丁苯酞联合法舒地尔对脑动脉瘤栓塞术后脑血管痉挛患者氧化应激及凋亡因子的影响  

Effect of Butylphthalide Combined with Fasudil on Oxidative Stress and Apoptotic Factors in Patients with Cerebral Vasospasm After Cerebral Aneurysm Embolization

作　　者：高良君 林秀琴 王斌[1] 章剑剑 GAO Liangjun;LIN Xiuqin;WANG Bin;ZHANG Jianjian(Huangmei County People's Hospital,Huanggang,Hubei,China 435500;Central South Hospital,Wuhan University,Wuhan,Hubei,China 430000)

机构地区：[1]湖北省黄梅县人民医院,湖北黄冈435500 [2]武汉大学中南医院,湖北武汉430000

出　　处：《中国药业》2023年第17期100-104,共5页China Pharmaceuticals

基　　金：国家自然科学基金[81671157]。

摘　　要：目的探讨丁苯酞联合法舒地尔治疗脑动脉瘤栓塞术后脑血管痉挛(CVS)的临床疗效,以及对患者氧化应激反应及凋亡因子水平的影响。方法选取湖北省黄梅县人民医院2020年6月至2022年8月收治的脑动脉瘤栓塞术后CVS患者86例,按随机抽签法分为观察组和对照组,各43例。两组患者均静脉滴注盐酸法舒地尔注射液,观察组患者加用丁苯酞氯化钠注射液静脉滴注,均治疗14 d。结果观察组总有效率为90.70%,显著高于对照组的72.09%(P<0.05)。治疗后,观察组患者美国国立卫生研究院卒中量表评分、血清神经元特异性烯醇化酶、S100钙结合蛋白β(S100β)、丙二醛、可溶性凋亡相关因子配体、可溶性凋亡相关因子水平及脑血管搏动指数、CVS指数均显著低于对照组(P<0.05),大脑中动脉平均血流速度、血清谷胱甘肽过氧化物酶及B淋巴细胞瘤-2水平均显著高于对照组(P<0.05)。观察组和对照组患者治疗期间不良反应发生率相当(11.63%比20.93%,P>0.05)。结论丁苯酞联合法舒地尔治疗脑动脉瘤栓塞术后CVS效果良好,可有效改善患者的脑组织血流动力学状态,减轻机体氧化应激反应,调控凋亡因子表达,促进神经功能恢复,且安全性良好。Objective To investigate the clinical efficacy of butylphthalide combined with fasudil in the treatment of patients with cerebral vasospasm(CVS)after cerebral aneurysm embolization,and its effect on the levels of oxidative stress and apoptotic factors.Methods A total of 86 patients with CVS after arterial embolization admitted to the hospital from June 2020 to August 2022 were selected and divided into the observation group and the control group by the random lottery method,with 43 cases in each group.The patients in the two groups were given intravenous drip of Fasudil Hydrochloride Injection,on this basis,the patients in the observation group were given intravenous drip of Butylphthalein Sodium Chloride Injection.Both groups were treated for 14 d.Results The total effective rate in the observation group was 90.70%,which was significantly higher than 72.09%in the control group(P<0.05).After treatment,the National Institutes of Health Stroke Scale(NIHSS)score,the levels of serum neuron-specific enolase(NSE),S100 calcium-binding proteinβ(S100β),malondialdehyde(MDA),soluble apoptosis-associated factor ligand(sFASL),soluble apoptosis-associated factor(sFAS),cerebrovascular pulsation index(PI),and CVS index in the observation group were significantly lower than those in the control group(P<0.05),while the mean blood flow velocity of the middle cerebral artery,and the levels of serum glutathione peroxidase and B-lymphocytoma-2 in the observation group were significantly higher than those in the control group(P<0.05).During treatment,the incidence of adverse reactions in the observation group was comparable to that in the control group(11.63%vs.20.93%,P>0.05).Conclusion Butanephthalein combined with fasudil is effective and safe in the treatment of patients with CVS after cerebral aneurysm embolization,which can effectively improve the cerebral blood flow,reduce the oxidative stress,regulate the expression of apoptotic factors,and promote the recovery of neurological function.

关 键 词：丁苯酞 法舒地尔 脑血管痉挛 脑动脉瘤栓塞术 氧化应激 凋亡因子 

分 类 号：R969.4[医药卫生—药理学] R971[医药卫生—药学]