两种钙拮抗剂用药方案对SAH病人脑血管痉挛发生率、生活质量及实验室指标的影响  

Influence of Two Kinds of Calcium Channel Antagonists Medication Regimens on the Incidence of Cerebral Vasospasm,Quality of Life and Laboratory Parameters in Patients with Subarachnoid Hemorrhage

作　　者：甘宁[1] 潘勤[1] 刘思思[1] 张晖[2] 张文亮[3] GAN Ning;PAN Qin;LIU Sisi;ZHANG Hui;ZHANG Wenliang(Baoding First Central Hospital,Baoding 071000,Hebei,China)

机构地区：[1]保定市第一中心医院,河北保定071000 [2]中国人民解放军252医院 [3]河北省第七人民医院

出　　处：《中西医结合心脑血管病杂志》2019年第19期3022-3025,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的 探讨钙拮抗剂静脉输注与脑池灌注对蛛网膜下腔出血(SAH)病人脑血管痉挛发生率、生活质量及实验室指标的影响。方法 选取我院2013年3月—2016年3月收治的SAH病人共100例,以随机数字表法分为对照组(50例)和观察组(50例),分别给予尼莫地平静脉输注(对照组)与脑池灌注辅助治疗(观察组),观察比较两组病人脑血管痉挛发生率、再出血发生率、死亡率及治疗前后Glasgow昏迷评分(GCS)、Barthel指数评分、血清基质金属蛋白酶(MMP-9)、红细胞生成素(EPO)、S-100钙结合蛋Bβ(S-100β)水平、脑积水发生率等。结果 观察组脑血管痉挛发生率、再出血发生率及死亡率均低于对照组(P<0.05);观察组治疗后GCS评分和Barthel指数评分均高于对照组及本组治疗前(P<0.05);观察组治疗后MMP-9、EPO及S-100β水平均优于对照组及本组治疗前(P<0.05);观察组脑积水发生率低于对照组(P<0.05)。结论 钙拮抗剂脑池灌注用于SAH病人治疗可有效避免脑血管痉挛发生,减轻神经功能损伤,提高生活质量,调节MMP-9、EPO及S-100β水平,并有助于降低再出血、死亡及脑积水发生风险,价值优于静脉输注治疗。Objective To investigate the influence of calcium channel antagonist medication regimens by intravenous drip and cerebral perfusion on the incidence of cerebral vasospasm,quality of life and laboratory parameters in patients with subarachnoid hemorrhage(SAH).Methods One hundred patients with SAH from March2013 to March2016 were randomly divided into two groups:control group( n =50) treated with nimodipine by intravenous infusion,and treatment group( n =50) treated with nimodipine by cerebral perfusion.The incidences of cerebral vasospasm,rebleeding,mortality,and hydrocephalus were compared between the two groups.Glasgow coma score(GCS),and Barthel index(BI) score were observed.The levels of serum matrix metalloproteinase(MMP-9),erythropoietin(EPO) S-100 calcium binding protein B beta(S-100 beta) were observed before and after treatment.Results The incidences of cerebral vasospasm,rebleeding,and mortality were significantly lower in treatment group than that in control group( P <0.05).The scores of GCS and BI were significantly higher in treatment group after treatment than that in control group and that before treatment( P <0.05).The levels of serum MMP-9,EPO,and S-100 beta were better in treatment group after treatment than that in control group and that before treatment( P <0.05).The incidence of hydrocephalus was lower in treatment group than that in control group( P < 0.05).Conclusion Calcium channel antagonists cerebral perfusion can effectively prevent cerebral vasospasm,relieve neurological damage,improve quality of life,regulate the levels of serum MMP-9,EPO,and S-100 beta,and be helpful to reduce the risk of rebleeding,death,and hydrocephalus in patients with SAH.

关 键 词：蛛网膜下腔出血 钙拮抗剂 静脉输注 脑池灌注 脑血管痉挛 神经功能损伤 生活质量 

分 类 号：R743[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]