依达拉奉联合尼莫地平治疗蛛网膜下腔出血后脑血管痉挛的临床疗效观察

摘要

目的：观察依达拉奉联合尼莫地平治疗蛛网膜下腔出血（ SAH）后脑血管痉挛（ CVS）的临床疗效。方法选择邳州市人民医院2014年1月—2015年1月收治的SAH后CVS患者50例，采用随机数字表法将患者分为观察组和对照组，各25例。对照组患者给予尼莫地平治疗，观察组患者给予依达拉奉联合尼莫地平治疗，治疗2周后比较两组患者临床疗效及治疗前后大脑中动脉收缩峰流速（ MCA Vp）和炎性因子〔肿瘤坏死因子α（ TNF-α）和白介素6（IL-6）〕水平。结果观察组患者临床疗效优于对照组（u=-1.987，P=0.047）。治疗前两组患者MCA Vp及TNF-α和IL-6水平比较，差异无统计学意义（ P>0.05）；治疗后观察组患者MCA Vp及TNF-α和IL-6水平低于对照组（P<0.05）。结论依达拉奉联合尼莫地平治疗SAH后CVS疗效确切，能有效降低患者MCA Vp，减轻炎性反应。%Objective To investigate the clinical effect of edaravone combined with nimodipine on cerebral vasospasm (CVS)after subarachnoid hemorrhage(SAH). Methods A total of 50 patients with CVS after SAH were selected in the People's Hospital of Pizhou from January 2014 to January 2015 , and they were randomly divided into observation group and control group,each of 25 cases. Patients of control group were treated with nimodipine,while patients of observation group were treated with edaravone combined with nimodipine,both groups treated for 2 weeks. Clinical effect,peak systolic velocity of middle cerebral artery(MCA Vp)and inflammatory factors(including TNF-α and IL-6)levels before and after treatment were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group(u= -1. 987,P=0. 047). No statistically significant differences of MCA Vp,TNF-α or IL-6 was found between the two groups before treatment(P >0. 05);while MCA Vp,TNF-α and IL-6 of observation group were statistically significantly lower than those of control group after treatment ( P<0. 05 ). Conclusion Edaravone combined with nimodipine has certain clinical effect on CVS after SAH,which can effectively reduce the MCA Vp and inflammatory reaction.