丙戊酸钠联合尼莫地平对蛛网膜下腔出血患者疗效及炎症反应的影响  

Efficacy of sodium valproate combined with nimodipine in treatment of patients with subarachnoid hemorrhage and its impact on inflammatory response

作　　者：张杰[1] 张列[1] 范英俊[1] 赵天全 夏勋 Zhang Jie;Zhang Lie;Fan Ying-jun;Zhao Tian-quan;Xia Xun(Department of Neurosurgery,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院神经外科,成都610500

出　　处：《中国药物应用与监测》2025年第2期194-197,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探究丙戊酸钠联合尼莫地平对蛛网膜下腔出血(subarachnoid hemorrhage,SAH)患者疗效及炎症反应的影响。方法回顾性分析2022年2月至2024年8月成都医学院第一附属医院予以针对性治疗的102例SAH患者的临床资料,根据用药方案差异分成两组。对照组49例采用尼莫地平治疗,观察组53例另外加用丙戊酸钠。两组患者均治疗3周。比较两组患者临床疗效、美国国立卫生研究院卒中量表评分、癫痫发作率、大脑中动脉血流速度、炎性因子水平及不良反应情况。结果观察组癫痫发作率[13.21%(7/53)]低于对照组[30.61%(15/49)](χ^(2)=4.559,P<0.05);观察组临床总有效率[96.23%(51/53)]高于对照组[83.67%(41/49)](χ^(2)=4.537,P<0.05);治疗后,观察组美国国立卫生研究院卒中量表评分、大脑中动脉血流速度及超敏C反应蛋白、白细胞介素8、肿瘤坏死因子α水平[分别为(6.93±1.42)分、(85.67±6.58)cm·s^(-1)、(182.68±21.60)ng·mL^(-1)、(1.46±0.28)ng·mL^(-1)、(0.27±0.06)ng·mL^(-1)]均低于对照组[分别为(7.79±1.56)分、(94.23±6.74)cm·s^(-1)、(205.43±25.51)ng·mL^(-1)、(2.38±0.32)ng·mL^(-1)、(0.34±0.07)ng·mL^(-1)](t=2.915、6.448、4.873、15.481、5.435,均P<0.05);不良反应总发生率观察组为20.75%(11/53),对照组为16.33%(8/49),两组比较差异无统计学意义(χ^(2)=0.329,P>0.05)。结论采用丙戊酸钠联合尼莫地平治疗SAH,能改善神经功能、促进脑血流恢复、预防癫痫、降低炎症反应,且具有较高的安全性。Objective To investigate the efficacy of sodium valproate combined with nimodipine in treatment of subarachnoid hemorrhage(SAH)and its impact on inflammatory response to provide reference for clinical medication.Methods Retrospective analysis of clinical data of 102 SAH patients receiving targeted treatment in The First Affiliated Hospital of Chengdu Medical College from February 2022 to August 2024 was conducted.Meanwhile,these 102 patients were divided into two groups based on differences in medication regimens.The 49 patients in the control group were treated with oral nifedipine,while the other 53 in the observation group were additionally treated with sodium valproate.All the patients in both groups were treated for 3 weeks.The clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,seizure rate,middle cerebral artery blood flow velocity,inflammatory factor levels and adverse reactions were compared between the two groups.Results Epileptic seizure rate in the observation group(13.21%(7/53))was lower than that in the control(30.61%(15/49))(χ^(2)=4.559,P<0.05).The total clinical effective rate of the observation group(96.23%(51/53))was higher than that of the control(83.67%(41/49))(χ^(2)=4.537,P<0.05).After treatment,the NIHSS score,middle cerebral artery blood flow velocity,and the level of high-sensitivity C-reactive protein,interleukin-8,tumor necrosis factor-αin the observation group((6.93±1.42)points,(85.67±6.58)cm·s^(-1),(182.68±21.60)ng·mL^(-1),(1.46±0.28)ng·mL^(-1),(0.27±0.06)ng·mL^(-1))were lower than those in the control((7.79±1.56)points,(94.23±6.74)cm·s^(-1),(205.43±25.51)ng·mL^(-1),(2.38±0.32)ng·mL^(-1),(0.34±0.07)ng·mL^(-1))(t=2.915,6.448,4.873,15.481,5.435,all P<0.05).No statistical difference was found in overall adverse reaction rate between the two groups(20.75%(11/53)vs 16.33%(8/49))(χ^(2)=0.329,P>0.05).Conclusion In the treatment of SAH,the combination of sodium valproate and nifedipine can improve neurological function,promote cerebral blood flow reco

关 键 词：丙戊酸钠 尼莫地平 蛛网膜下腔出血 炎症反应 临床疗效 

分 类 号：R743.35[医药卫生—神经病学与精神病学]