依达拉奉配合醒脑静注射液治疗脑出血临床疗效及对神经细胞因子和炎性反应递质的影响  

The clinical effect of edaravone combined with xingnaojing injection in the treatment of cerebral hemorrhage and its effect on nerve cytokines and inflammatory transmitters

作　　者：石代乐[1] 高继英[2] 杨李鹏[3] 王鹏飞[3] 史新乐 乔建新[1] 虞剑 刘熙鹏[1] SHI Dai-le;GAO Ji-ying;YANG Li-peng;WANG Peng-fei;SHI Xin-le;QIAO Jian-xin;YU Jian;LIU Xi-peng(Department of Neurosurgery,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Hyperbaric Oxygen Chamber,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Emergency,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Imaging Center,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Neurosurgery,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]河北北方学院附属第一医院神经外科,河北张家口075000 [2]河北北方学院附属第一医院高压氧舱室,河北张家口075000 [3]河北北方学院附属第一医院急诊科,河北张家口075000 [4]河北北方学院附属第一医院影像中心,河北张家口075000 [5]复旦大学附属华山医院神经外科,上海200040

出　　处：《实用医院临床杂志》2022年第4期36-40,共5页Practical Journal of Clinical Medicine

基　　金：张家口市科技攻关计划项目(编号:1521107D)。

摘　　要：目的分析依达拉奉配合醒脑静注射液治疗脑出血临床作用。方法收集96例脑出血患者的临床资料。根据不同药物治疗方案分为A组(n=47,静脉滴注依达拉奉注射液)与B组(n=49,静脉滴注依达拉奉+醒脑静注射液)。比较两组治疗后临床效果、神经细胞因子情况、炎性递质反应情况、不良反应发生率及治疗前后NIHSS评分情况。结果B组治疗后基本痊愈率、总有效率均高于A组(P<0.05);用药后,两组脑源性神经营养因子(BDNF)、人血管内皮生长因子(VEGF)升高,神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、内皮素-1(ET-1)、D-二聚体、人S100B蛋白(S-100B)、鞘碱性蛋白(MBP)降低(P<0.05),B组BDNF、VEGF高于A组,GFAP、NSE、S-100B、MBP、D-二聚体、ET-1低于A组(P<0.05);用药后,两组降钙素原、α1-抗胰蛋白酶、细胞介素-1β、水通道蛋白质-4、白介素-6、高迁移率族蛋白1、C-反应蛋白、纤维连接蛋白降低,B组各项指标均低于A组(P<0.05);B组NIHSS评分低于A组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论醒脑静注射液联用依达拉奉注射液治疗脑出血患者临床疗效显著,能够有效清除自由基和促进神经细胞功能修复,降低炎性反应,安全性较高。Objective To analyze the clinical effects of edaravone combined with Xingnaojing injection in the treatment of cerebral hemorrhage.Methods Clinical data of 96 patients with cerebral hemorrhage were collected.According to different drug treatment regiments,they were divided into a group A(n=47,edaravone intravenous infusion)and a group B(n=49,edaravone intravenous infusion+xingnaojing intravenous infusion).The clinical effect,neurocytokine status,inflammatory transmitter response,incidence of adverse reactions and NIHSS score were compared between the two groups before and after treatment.Results The basic recovery rate and total effective rate in the group B were higher than those in the group A(P<0.05).After treatment,brain-derived neurotrophic factor(BDNF)and vascular endothelial growth factor(VEGF)were significantly increased in both groups,while neuron-specific enolase(NSE),glial fibrillary acidic protein(GFAP),endothelin-1(ET-1),D-dimer,S100B protein(S-100B)and sheath basic protein(MBP)were significantly decreased(P<0.05).The levels of BDNF and VEGF in the group B were higher than those in the group A.The levels of GFAP,NSE,S-100B,MBP,D-dimer and ET-1 in the group B were lower than those in the group A(P<0.05).After treatment,procalcitonin,α1-antitrypsin,interleukin-1β,aquaporin-4,interleukin-6,high mobility group box 1,C-reactive protein,and fibronectin were decreased in both groups,and group B were significantly lower than those in the group A(P<0.05).The NIHSS score of the group B was significantly lower than that of the group A(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Xingnaojing injection combined with edaravone injection has significant clinical efficacy in the treatment of patients with cerebral hemorrhage.It can effectively remove the free radicals and promote the functional repair of nerve cells,and reduce the inflammatory reaction.The safety is high.

关 键 词：醒脑静 依达拉奉 神经细胞因子 炎性递质反应 

分 类 号：R743.34[医药卫生—神经病学与精神病学]