尼莫地平联合微创穿刺清除术对高血压脑出血患者神经功能、血流动力学及血清炎症因子水平的影响  

Effect of nimodipine combined with minimally invasive puncture on neurological function,hemodynamics and serum inflammatory factor levels in patients with hypertensive intracerebral hemorrhage

作　　者：胡洋洋[1] 王常娟[2] 杜静静[3] 苟秉林[1] 张龙[1] 刘扬 王腾飞 HU Yangyang;WANG Changjuan;DU Jingjing;GOU Binglin;ZHANG Long;LIU Yang;WANG Tengfei(Department of Neurosurgery,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei Province,China;Functional Department,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei Province,China;Department of Hand Anesthesiology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei Province,China;Department of Medical Imaging,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei Province,China;Clinical Laboratory,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei Province,China)

机构地区：[1]河北北方学院附属第二医院神经外科,河北张家口075100 [2]河北北方学院附属第二医院功能科,河北张家口075100 [3]河北北方学院附属第二医院手麻科,河北张家口075100 [4]河北北方学院附属第二医院医学影像科,河北张家口075100 [5]河北北方学院附属第二医院检验科,河北张家口075100

出　　处：《新乡医学院学报》2024年第9期852-856,861,共6页Journal of Xinxiang Medical University

基　　金：张家口市重点研发计划项目(编号:2121081D)。

摘　　要：目的探讨尼莫地平联合微创穿刺清除术对高血压脑出血(HICH)患者神经功能、血流动力学及血清炎症因子水平的影响。方法选择2019年6月至2022年5月河北北方学院附属第二医院收治的108例HICH患者为研究对象,根据治疗方法将患者分为观察组(n=55)和对照组(n=53)。2组患者均给予微创穿刺清除术,在此基础上观察组患者加用尼莫地平治疗1个月。采用美国国立卫生研究院卒中量表(NIHSS)评分评估2组患者治疗前后神经功能缺损情况;分别于治疗前后抽取患者晨起空腹静脉血5 mL,离心取血清,采用酶联免疫吸附试验检测患者血清中脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平;超声经颅多普勒血流分析仪监测2组患者治疗前后平均血流速度(Vm)、阻力指数(RI)、搏动指数(PI)等血流动力学指标;记录治疗后2组患者头痛、头晕、感染、再出血等不良反应发生情况。结果治疗前2组患者的NIHSS评分及血清NSE、BDNF水平比较差异无统计学意义(P>0.05)。2组患者治疗后NIHSS评分和血清NSE水平显著低于治疗前,血清BDNF水平显著高于治疗前(P<0.05)。治疗后,观察组患者NIHSS评分和血清NSE水平显著低于对照组,血清BDNF水平显著高于对照组(P<0.05)。治疗前2组患者的Vm、PI、RI比较差异无统计学意义(P>0.05)。2组患者治疗后的Vm、PI显著高于治疗前,RI显著低于治疗前(P<0.05)。治疗后,观察组患者的Vm、PI显著高于对照组,RI显著低于对照组(P<0.05)。2组患者治疗前血清TNF-α、IL-6、CRP水平比较差异无统计学意义(P>0.05)。2组患者治疗后血清TNF-α、IL-6、CRP水平显著低于治疗前(P<0.05)。治疗后,观察组患者血清TNF-α、IL-6、CRP水平显著低于对照组(P<0.05)。对照组和观察组患者不良反应发生率分别为7.55%(4/53)、9.09%(5/55),2组患者不良反应发生�Objective To explore the effect of nimodipine combined with minimally invasive puncture on neurological function,hemodynamics,and serum inflammatory factor levels in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 108 patients with HICH treated at the Second Affiliated Hospital of Hebei North University from June 2019 to May 2022 were selected as the research subjects.They were divided into an observation group(n=55)and a control group(n=53)according to the treatment method.All patients in the two groups received minimally invasive puncture;on this basis,the patients in the observation group were treated with nimodipine for one month.The neurological deficit of patients in the two groups was evaluated by the National Institute of Health Stroke Scale(NIHSS)score before and after treatment.Before and after treatment,5 mL of fasting venous blood was taken from patients in the morning,and the serum was obtained by centrifugation.The serum levels of brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were detected by enzyme-linked immunosorbent assay.Ultrasonic transcranial Doppler blood flow analyzer was used to monitor the hemodynamic indexes such as mean blood flow velocity(Vm),resistance index(RI)and pulsitility index(PI)of patients in the two groups before and after treatment.The adverse reactions such as headache,dizziness,infection and rebleeding were recorded in the two groups after treatment.Results There was no statistically significant difference in the NIHSS score and serum NSE and BDNF levels between the two groups before treatment(P>0.05).After treatment,the NIHSS score and serum NSE level of patients in the two groups were significantly lower than those before treatment,while the serum BDNF level was significantly higher than that before treatment(P<0.05).After treatment,the NIHSS score and serum NSE level of patients in the observation group were significantly lower than those in

关 键 词：尼莫地平 微创穿刺清除术 高血压脑出血 神经功能 血流动力学 炎症因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]