丁苯酞注射液对动脉瘤性蛛网膜下腔出血脑血管痉挛患者血清神经特异性烯醇酶、C-反应蛋白及脂肪酸结合蛋白水平的影响

Effect of butylphthalide injection on serum neuron specific enolase,C-reactive protein and fatty acid binding protein levels in patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage

探讨丁苯酞注射液对动脉瘤性蛛网膜下腔出血脑血管痉挛患者血清神经特异性烯醇酶、C-反应蛋白及脂肪酸结合蛋白水平的影响。方法收集福建医科大学附属第一医院神经外科收治的动脉瘤性蛛网膜下腔出血术后脑血管痉挛患者90例,分为对照组和实验组,每组各45例,对照组给予尼莫地平和"3H"疗法等常规动脉瘤治疗方法,实验组在对照组的基础上静脉使用丁苯酞注射液。比较患者治疗前后经颅多普勒(transcranial doppler,TCD)血流参数、血清神经特异性烯醇酶(neuron specific enolase,NSE)、脂肪酸结合蛋白(fatty acid binding protein,FABP)、C-反应蛋白(C-reactive protein,CRP)水平。结果实验组患者与对照组相比大脑中动脉血流痉挛参数明显改善(P<0.05);实验组患者治疗后的血清NSE、CRP、FABP水平较低(P<0.05);实验组患者与对照组比较其脑梗死率较低(P<0.05)。结论丁苯酞注射液能够显著降低动脉瘤性蛛网膜下腔出血脑血管痉挛患者血清NSE、CRP以及FABP水平,改善脑部血流,是治疗动脉瘤性蛛网膜下腔出血脑血管痉挛患者的一种有效的联合疗法。

To investigate influence of butylphthalide injection on serum neuron specific enolase,C-reactive protein and fatty acid binding protein levels in patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Methods Ninety patients with cerebral vasospasm were admitted to The First Affiliated Hospital of Fujian Medical University,then the patients were divided into two groups: The control group( 45 patients)was treated with nimodipine and triple-H therapy after surgery; in addition to nimodipine and triple-H therapy,butylphthalide injection was administered to the experimental group( 45 patients). Transcranial doppler( TCD) was used for the evaluating cerebral artery blood flow velocity,and the serum neuron specific enolase( NSE),C-reactive protein( CRP) and fatty acid binding protein( FABP) levels in patients with cerebral vasospasm were measured.Results The experimental group improved significantly more than the control group,a significant decrease in cerebral blood flow velocity of the middle cerebral artery in the experimental group as measured by TCD( P < 0. 05). The serum levels of NSE,CRP and FABP in the patients in the experimental group decreased more significantly( P < 0. 05). And the incidence of cerebral infarction in experimental group was lower than that in control group( P <0. 05). Conclusion The serum levels of NSE,CRP and FABP in the patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage could be significantly reduced by administration of butylphthalide injection,which also could improve cerebral blood supply. Therefore,administration of butylphthalide injection is an effective treatment for cerebral vasospasm.