显微外科手术联合自体骨髓干细胞动员及辛伐他汀治疗高血压脑出血  

Microsurgery combined with therapy of autologous bone marrow stem cells mobilization and simvastatin for hypertensive cerebral hemorrhage

作　　者：步星耀[1] 程培训[2] 姜金豆[1] 王新军[2] 

机构地区：[1]河南省人民医院神经外科,郑州市450003 [2]郑州大学第五附属医院神经外科,郑州市450052

出　　处：《中华实用诊断与治疗杂志》2010年第12期1175-1178,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省科技攻关重点项目(0424410054)

摘　　要：目的:探讨显微外科手术联合自体骨髓干细胞动员及辛伐他汀治疗高血压脑出血的疗效和安全性。方法:60例高血压脑出血患者依治疗方案不同分为4组:A组,显微外科手术治疗15例;B组,显微外科手术及辛伐他汀治疗15例;C组,显微外科手术联合自体骨髓干细胞动员治疗15例;D组,显微外科手术联合自体骨髓干细胞动员及辛伐他汀治疗15例。采用流式细胞仪于术前以及手术后3周测定各组外周血CD133+CD34+细胞数。分别于术前以及术后1,3,6个月行神经功能缺损评分(NIHSS评分)和日常生活能力评定(Barthel指数),观察有无不良反应。结果:C,D组术后3周外周血CD133+CD34+细胞数均高于治疗前(P<0.05),且分别高于A,B组(P<0.05)。术前4组患者NIHSS评分及Barthel指数比较差异无统计学意义(P>0.05);术后各时间点4组患者NIHSS评分均依次降低,Barthel指数均依次升高,与术前比较差异均有统计学意义(P<0.05);同一时间点C,D组与A,B组NIHSS评分、Barthel指数比较差异均有统计学意义(P<0.05),术后3,6个月时C,D组NIHSS评分及Barthal指数比较差异均有统计学意义(P<0.05)。患者均未出现明显不良反应。结论:显微外科手术联合自体骨髓干细胞动员及辛伐他汀治疗高血压脑出血,疗效显著,安全性高。Objective To observe the effect and safety of microsurgery combined with therapy of autologous bone marrow stem cells mobilization and simvastatin for hypertensive cerebral hemorrhage.Methods Sixty cases of hypertensive cerebral hemorrhage were divided into group A receiving microsurgery,group B receiving microsurgery and simvastain,group C receiving microsurgery and autologous bone marrow stem cells mobilization treatment and group D receiving the combination therapy of autologous bone marrow stem cells mobilization and simvastatin after microsurgery,15 cases each.CD133＋CD34＋ cells were detected before and 3 weeks after microsurgery by flow cytometry.Neurological impairment（NIHSS score） and activities of daily living（Barthel index） were evaluated before and after microsurgery 1,3 and 6 months,meanwhile the adverse reaction was observed.Results CD133＋CD34＋ cells three weeks were higher after microsurgery than those before microsurgery in group C and D（P0.05）,and were higher than those in group A and B（P0.05）.The NIHSS score and Barthel index were not significantly different in four groups before microsurgery（P0.05）.In 1,3 and 6 months after treatment,the NIHSS scores of group A,B,C and D stepped down,and the Barthel index stepped up in turn,which showed significant differences compared with those before treatment.While compared group C and D with group A and B,there were significantly differences（P0.05）.There were significantly differences between group C and D in 3 and 6 months after microsurgery.No adverse reaction was found.Conclusion Microsurgery combined with autologous bone marrow stem cells mobilization and simvastatin is effective and safe for hypertensive cerebral hemorrhage.

关 键 词：显微外科手术 脑出血 骨髓干细胞 动员 辛伐他汀 

分 类 号：R651.11[医药卫生—外科学]