甲磺酸倍他司汀联合纳洛酮对后循环缺血性眩晕患者血管内皮功能及血流动力学的影响  

Effects of naloxone combined with betahistine mesylate on hemodynamics and vascular endothelial function in patients with posterior circulation ischemic vertigo

作　　者：张依璐 郑珂珂 郭东方 杨牧[1] 张誓伟[1] Zhang Yilu;Zheng Keke;Guo Dongfang;Yang Mu;Zhang Shiwei(Department of Neurology,The Second People's Hospital of Nanyang City,Nanyang 473000,China)

机构地区：[1]南阳市第二人民医院神经内科,南阳473000

出　　处：《中国临床实用医学》2024年第2期8-13,共6页China Clinical Practical Medicine

摘　　要：目的探究甲磺酸倍他司汀联合纳洛酮治疗后循环缺血性眩晕(PCIV)的效果及对血管内皮功能、椎-基底动脉血流动力学的影响。方法本研究为病例对照研究,选取2022年3月至2023年10月南阳市第二人民医院神经内科收治的108例PCIV患者,男68例,女40例,年龄(55.96±2.86)岁,年龄范围为45~65岁。根据不同治疗方案将患者分为单药治疗组(n=53)与联合治疗组(n=55),单药治疗组采用甲磺酸倍他司汀治疗,联合治疗组采用甲磺酸倍他司汀联合纳洛酮治疗。治疗10 d后,比较两组患者治疗效果、症状评分[欧洲眩晕评价量表(EEV)、眩晕障碍量表(DHI)]、椎-基底动脉血流动力学[椎动脉及基底动脉的血管阻力指数(RI)、平均血流速度(Vm)、收缩期血流峰流速(Vs)]、血管内皮功能相关指标[血管性血友病因子(vWF)、降钙素基因相关肽(CGRP)、内皮素-1、髓样细胞触发受体样转录因子1(sTLT-1)]及不良反应发生率。结果联合治疗组治疗有效率[96.4%(53/55)]高于单药治疗组[83.0%(44/53)],差异有统计学意义(P<0.05)。治疗后联合治疗组EEV[(6.26±1.05)分]、DHI评分[(12.59±2.05)分]均低于单药治疗组[(7.83±1.18)分,(15.64±2.71)分],椎动脉RI(0.62±0.08)与基底动脉RI(0.60±0.09)均低于单药治疗组(0.68±0.10、0.67±0.12),椎动脉Vm[(33.64±3.63)cm/s]、基底动脉Vm[(39.62±4.05)cm/s]、椎动脉Vs[(42.50±4.81)cm/s]及基底动脉Vs[(41.25±4.82)cm/s]均高于单药治疗组[(30.58±2.98)cm/s、(36.85±3.76)cm/s、(38.96±4.28)cm/s、(37.80±5.12)cm/s],vWF[(80.36±6.14)%]、内皮素-1[(45.61±5.70)mmoL/L]、sTLT-1[(426.39±48.60)pg/ml]均低于单药治疗组[(84.52±4.58)%、(50.34±4.96)mmoL/L、(459.98±50.24)pg/ml],CGRP[(50.25±4.73)ng/L]高于单药治疗组[(46.92±5.01)ng/L],差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论甲磺酸倍他司汀联合纳洛酮治疗PCIV治疗效果确切,可改善血管内皮功Objective To investigate the effect of betahistine mesylate combined with naloxone on posterior circulation ischemic vertigo(PCIV)and its impact on vascular endothelial function and vertebrobasilar artery hemodynamics.Methods This study was a case-control study,a total of 108 patients were selected from the department of Neurology of Second People's Hospital of Nanyang City from March 2022 to October 2023,including 68 males and 40 females,aged(55.96±2.86)years old,the age ranging from 45 to 65 years old.According to different treatment regimens,patients were divided into single-drug treatment group(n=53)and combination treatment group(n=55).The single-drug treatment group was treated with betahistine mesylate,while the combination treatment group was treated with betahistine mesylate combined with naloxone.After 10 days of treatment,the therapeutic effects,symptom scores[european vertigo evaluation scale(EEV),dizziness handicap index(DHI)],vertebrobasilar hemodynamics[vascular resistance index(RI),mean blood flow velocity(Vm),systolic peak blood flow velocity(Vs)]of vertebral artery and basilar artery,vascular endothelial function-related indicators[von willebrand factor(vWF),calcitonin gene-related peptide(CGRP),endothelin-1,myeloid cell triggering receptor-like transcription factor 1(sTLT-1)],and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combination treatment group[96.4%(53/55)]was higher than that of the single-drug treatment group[83.0%(44/53)],and the difference was statistically significant(P<0.05).After treatment,the EEV[(6.26±1.05)scores]and DHI score[(12.59±2.05)scores]in the combination treatment group were lower than those in the single-drug treatment group[(7.83±1.18)scores,(15.64±2.71)scores],and the RI of the vertebral artery(0.62±0.08)and the RI of the basilar artery(0.60±0.09)were lower than those in the single-drug treatment group(0.68±0.10,0.67±0.12),the vertebral artery Vm[(33.64±3.63)cm/s],basilar artery Vm[(39.62±4.0

关 键 词：甲磺酸倍他司汀 纳洛酮 后循环缺血性眩晕 椎-基底动脉血流动力学 血管内皮功能 

分 类 号：R741[医药卫生—神经病学与精神病学]