颅内血肿微创清除术联合吡拉西坦治疗脑出血的疗效及对血清HMGB-1、IGF-1水平的影响
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摘要
目的观察颅内血肿微创清除术联合吡拉西坦治疗脑出血的疗效及对血清HMGB-1、IGF-1水平的影响。方法收集2016年1月-2017年12月于本院神经外科住院的脑出血患者,按照数字随机分组法分为观察组和对照组,观察组采用颅内血肿微创清除术联合吡拉西坦,对照组采用颅内血肿微创清除术,比较2组患者的疗效、治疗前后血清HMGB-1、IGF-1水平的变化及不良反应。结果观察组的有效率为95.0%,高于对照组(75.0%)(P<0.05);治疗前2组患者的血清HMGB-1分别为(7.43±0.31)ng/mL、(7.36±0.35)ng/mL,治疗后分别为(1.54±0.46)ng/mL、(2.90±0.48)ng/mL,治疗后2组患者的血清HMGB-1水平均有所降低(P<0.05),且观察组较对照组下降明显(P<0.05);治疗前2组患者的血清IGF-1水平分别为(31.21±5.12)、(31.18±4.95),治疗后分别为(52.33±6.24)、(45.48±5.91),治疗后2组患者的血清IGF-1水平均有所升高(P<0.05),且观察组较对照组升高明显(P<0.05);2组患者不良反应发生率分别为20.0%、12.5%,2组比较无明显差异(P>0.05)。结论颅内血肿微创清除术联合吡拉西坦治疗脑出血能够显著提高其治疗效果,有助于降低血清HMGB-1水平,提高血清IGF-1水平,且安全性较好。
Objective To observe the effects of minimally invasive removal of intracranial hematoma combined with piracetam in the treatment of intracerebral hemorrhage and its effect on serum HMGB-1、IGF-1 level.Methods The patients with intracerebral hemorrhage who were hospitalized in neurosurgery department from January 2016 to December 2017 were randomly divided into observation group and control group.The observation group was treated with minimally invasive removal of intracranial hematoma combined with piracetam.The control group was treated with minimally invasive removal of intracranial hematoma.The changes of serum HMGB-1、IGF-1 levels and adverse reactions were compared between the two groups before and after treatment.Results The effective rate of observation group was 95.0,which was higher than that of control group 75.0%(P < 0.05).The serum HMGB-1 levels of the two groups were(7.43±0.31)ng/mL、(7.36±0.35)ng/mL before treatment and(1.54±0.46)ng/mL、(2.90±0.48)ng/mL after the treatment,the serum HMGB-1 levels were all decreased(P<0.05),and the serum HMGB-1 level of the observation group was significantly lower than that of the control group(P<0.05).The serum IGF-1 levels of the former two groups were(31.21±5.12)nmol/L、(31.18±4.95)nmol/L before treatment and(52.33±6.24)nmol/L、(45.48±5.91)nmol/L after treatment,the serum IGF-1 levels of the two groups were increased significantly(P<0.05).The incidence of adverse reactions was 20.0% in the observation group and 12.5% in the control group,and there was no significant difference between the two groups(P>0.05).Conclusion Minimally invasive removal of intracranial hematoma combined with piracetam in the treatment of intracerebral hemorrhage could significantly improve its therapeutic effect,help to reduce the level of serum HMGB-1 and increase the level of serum IGF-1,and the safety was good.
Objective To observe the effects of minimally invasive removal of intracranial hematoma combined with piracetam in the treatment of intracerebral hemorrhage and its effect on serum HMGB-1、IGF-1 level.Methods The patients with intracerebral hemorrhage who were hospitalized in neurosurgery department from January 2016 to December 2017 were randomly divided into observation group and control group.The observation group was treated with minimally invasive removal of intracranial hematoma combined with piracetam.The control group was treated with minimally invasive removal of intracranial hematoma.The changes of serum HMGB-1、IGF-1 levels and adverse reactions were compared between the two groups before and after treatment.Results The effective rate of observation group was 95.0,which was higher than that of control group 75.0%(P < 0.05).The serum HMGB-1 levels of the two groups were(7.43±0.31)ng/mL、(7.36±0.35)ng/mL before treatment and(1.54±0.46)ng/mL、(2.90±0.48)ng/mL after the treatment,the serum HMGB-1 levels were all decreased(P<0.05),and the serum HMGB-1 level of the observation group was significantly lower than that of the control group(P<0.05).The serum IGF-1 levels of the former two groups were(31.21±5.12)nmol/L、(31.18±4.95)nmol/L before treatment and(52.33±6.24)nmol/L、(45.48±5.91)nmol/L after treatment,the serum IGF-1 levels of the two groups were increased significantly(P<0.05).The incidence of adverse reactions was 20.0% in the observation group and 12.5% in the control group,and there was no significant difference between the two groups(P>0.05).Conclusion Minimally invasive removal of intracranial hematoma combined with piracetam in the treatment of intracerebral hemorrhage could significantly improve its therapeutic effect,help to reduce the level of serum HMGB-1 and increase the level of serum IGF-1,and the safety was good.
引文
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[10]Watanabe M,Miyajima Masakazu,Nakajima M,et al.Expression analysis of high mobility group box-1 protein(HMGB-1)in the cerebral cortex,hippocampus,and cerebellum of the congenital hydrocephalus(H-Tx)rat[J].Acta Neurochirurgica.Supplement,2012,113(113):91-96.
[11]Wadowska M,Woods J,Rogozinska M,et al.Neuroprotective effects of enriched environment housing after transient global cerebral ischaemia are associated with the upregulation of insulin-like growth factor-1 signalling[J].Neuropathology and Applied Neurobiology,2015,41(4):544-556.
[12]杜春亮,李娜,赵云洁,等.NT-proBNP、IGF-1、HIF-1α水平与脑出血患者预后的关系[J].检验医学与临床,2017,9(18):2707-2710.
[13]Aoi N,Nakayama T,Soma M,et al.The insulin-like growth factor-1 gene is associated with cerebral infarction in Japanese subjects[J].Hereditas,2012,149(5):153-162.
[14]唐志,李宗平.吡拉西坦联合七叶皂苷钠治疗脑出血的临床研究[J].现代药物与临床,2017,32(8):1425-1428.
[2]王京娥,陈燕,高山,等.IGF-1、HMGB-1、GSN和MIF水平在高血压脑出血中的意义[J].河北医药,2016,38(18):2733-2736.
[3]王明,陈建明.依达拉奉联合吡拉西坦治疗急性脑出血的疗效观察[J].中国实用神经疾病杂志,2013,16(24):88-89.
[4]Hemphill C J.自发性脑出血诊疗指南---美国心脏协会/美国卒中协会的健康职业者指南[J].中国脑血管病杂志,2015,12(9):490-504.
[5]Lin Cheng,Zhao Yuan-li,Wan Gang,et al.Effects of simvastatin and taurine on delayed cerebral vasospasm following subarachnoid hemorrhage in rabbits[J].Experimental and Therapeutic Medicine,2016,11(4):1355-1360.
[6]吴勇,谭志红,梁土焕,等.磁共振快速场回波技术在急性脑出血诊断中的应用[J].白求恩医学杂志,2014,12(4):389-390.
[7]Amemiya S,Kamiya T,Nito C,et al.Anti-apoptotic and neuroprotective effects of edaravone following transient focal ischemia in rats[J].European Journal of Pharmacology,2005,516(2):125-130.
[8]王加光.颅内血肿微创清除术联合神经节苷脂治疗脑出血的临床效果观察[J].中国医药指南,2015,13(27):5-5,6.
[9]Koga M,Toyoda K.Medical therapy for intracranial hemorrhage:update blood pressure management for prevention and acute treatment[J].Rinsho Shinkeigaku,2012,52(11):1110-1112.
[10]Watanabe M,Miyajima Masakazu,Nakajima M,et al.Expression analysis of high mobility group box-1 protein(HMGB-1)in the cerebral cortex,hippocampus,and cerebellum of the congenital hydrocephalus(H-Tx)rat[J].Acta Neurochirurgica.Supplement,2012,113(113):91-96.
[11]Wadowska M,Woods J,Rogozinska M,et al.Neuroprotective effects of enriched environment housing after transient global cerebral ischaemia are associated with the upregulation of insulin-like growth factor-1 signalling[J].Neuropathology and Applied Neurobiology,2015,41(4):544-556.
[12]杜春亮,李娜,赵云洁,等.NT-proBNP、IGF-1、HIF-1α水平与脑出血患者预后的关系[J].检验医学与临床,2017,9(18):2707-2710.
[13]Aoi N,Nakayama T,Soma M,et al.The insulin-like growth factor-1 gene is associated with cerebral infarction in Japanese subjects[J].Hereditas,2012,149(5):153-162.
[14]唐志,李宗平.吡拉西坦联合七叶皂苷钠治疗脑出血的临床研究[J].现代药物与临床,2017,32(8):1425-1428.