双重抗血小板聚集联合血管介入栓塞术对蛛网膜 下腔出血患者神经功能、动脉血流指标的影响  

Effect of dual antiplatelet aggregation combined with vascular interventional embolization on nerve function and arterial flow indexes in patients with subarachnoid hemorrhage

作　　者：周小荔 谈小红 查继辉 王玉霞 苟理宏 张旭东 杨阳 ZHOU Xiaoli;TAN Xiaohong;CHA Jihui;WANG Yuxia;GOU Lihong;ZHANG Xudong;YANG Yang(Deurosurgery department,Longnan First People’s Hospital,Longnan 746000,China)

机构地区：[1]陇南市第一人民医院神经外科,甘肃省陇南市746000

出　　处：《中国煤炭工业医学杂志》2025年第1期63-68,共6页Chinese Journal of Coal Industry Medicine

基　　金：陇南市科技计划项目(编号:2022-S·JH-21)。

摘　　要：目的探讨双重抗血小板聚集联合血管介入栓塞术对蛛网膜下腔出血患者神经功能、动脉血流指标的影响。方法随机选取2022年9月-2023年9月于陇南市第一人民医院治疗的蛛网膜下腔出血患者80例,以随机数字表法分为观察组和对照组,各40例。对照组采用血管介入栓塞术方式治疗,观察组采用双重抗血小板聚集联合血管介入栓塞术方式进行治疗,观测两组患者栓塞效果、格拉斯哥量表(GCS)及美国院卒中量表(NIHSS)评分、血清胶质纤维酸性蛋白(CFAP)、中枢神经特异性蛋白β(S100β)、神经元特异性烯醇化酶(NSE)、单核细胞趋化蛋白(MCP-1)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)水平、脑动脉血流速度、临床疗效、不良反应发生率。结果较治疗前,治疗后各组S100β(t=10.884、13.571)、NSE(t=5.441、7.820)、CFAP(t=21.981、28.273)、MCP-1(t=7.950、10.523)、动脉血流速度(t=10.545、6.803、8.707、14.867、20.851、15.172)、GCS(t=11.793、20.837)及NIHSS评分(t=19.956、24.351)水平降低,TNF-α(t=11.529、7.751)、CRP(t=23.214、10.027)水平升高,差异均有统计学意义(P<0.05);相较于对照组,观察组患者的完全栓塞比例(x^(2)=5.013)、总有效率(x^(2)=8.022)明显升高,不完全栓塞比例(x²=5.165)、脑动脉血流速度(t=7.927、8.612、9.057)、不良反应发生率(x^(2)=2.505)、GCS(t=8.248)及NIHSS评分(t=5.112)、CFAP(t=7.027)、S100β(t=4.438)、NSE(t=3.246)、MCP-1(t=4.237)、TNF-α(t=4.911)、CRP(t=9.010)水平明显下降,差异均有统计学意义(P<0.05)。结论双重抗血小板聚集联合血管介入栓塞术能够有效改善蛛网膜下腔出血患者的脑组织损伤、炎症反应和神经功能状态,动脉血流指标明显降低,在一定程度上降低患者高病死率、致残率及不良反应发生率,有利于改善临床预后,具有临床效果。Objective To investigate the effects of dual antiplatelet aggregation combined with vascular interventional embolization on nerve function and arterial blood flow in patients with subarachnoid hemorrhage.Methods A total of eighty patients with subarachnoid hemorrhage treated in our hospital from September 2022 to September 2023 were randomly divided into observation group and control group by random number table method,with 40 cases in each group.The control group was treated with interventional vascular embolization,and the observation group was treated with dual antiplatelet aggregation combined with interventional vascular embolization.Embolization effect,Glasgow coma scale(GCS)and American Hospital stroke scale(NIHSS)scores,serum glial fibrinous acidic protein(CFAP),central nervous specific proteinβ(S10Oβ),neuron-specific enolase(NSE),monocyte chemotactic protein(MCP-1),tumor necrosis fact-α(TNF-α)were observed in two groupsα,C-reactive protein(CRP)level,cerebral artery flow velocity,clinical efficacy,incidence of adverse reactions.Results Compared to before treatment,S100β(t=10.884,13.571),NSE(t=5.441,7.820),CFAP(t=21.981,28.273),MCP-1(t=7.950,10.523),arterial flow velocity(t=10.545,6.803,8.707,14.867,20.851,15.172),GCS(t=11.793,20.837)and NIHSS score(t=19.956,24.351)in each group after treatment were decreased,TNF-α(t=11.529,7.751)and CRP(t=23.214,10.027)were increased.The difference was statistically significant(P<0.05).Compared with the control group,the proportion of complete embolization(x^(2)=5.013)and the total effective rate(x^(2)=8.022)in the observation group were significantly increased.The proportion of incomplete embolization(x^(2)=5.165),cerebral artery flow velocity(t=7.927,8.612,9.057),incidence of adverse reactions(x^(2)=2.505),GCS(t=8.248),NIHSS score(t=5.112),the levels of CFAP(t=7.027),S100β(t=4.438),NSE(t=3.246),MCP-1(t=4.237),TNF-α(t=4.911)and CRP(t=9.010)were significantly decreased,and the difference was statistically significant(P<0.05).Conclusion Dual antiplatelet aggregati

关 键 词：双重抗血小板 血管介入栓塞术 蛛网膜下腔出血 动脉血流指标 神经功能 

分 类 号：R732.2[医药卫生—肿瘤]