依达拉奉联合尼莫地平对高血压脑出血患者脑血流、血清NO、MDA、HMGB1的影响
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摘要
目的探讨依达拉奉联合尼莫地平治疗高血压脑出血(HICH)患者对其脑血流动力学、血清一氧化氮(NO)、丙二醛(MDA)、高迁移率族蛋白1(HMGB1)的影响。方法选取我院收治的108例HICH患者,收集时间2016年4月至2017年5月,其中54例患者给予基础治疗+依达拉奉+尼莫地平(研究组)、另外54例患者采用基础治疗+尼莫地平治疗(对照组),对比两组患者治疗前后的神经功能缺损评分(NIHSS)、血清NO、MDA、HMGB1水平、水肿面积、血肿量、脑血流动力学参数。结果治疗前,两组患者的NIHSS评分差异无统计学意义(P>0. 05);治疗2周后,研究组患者的NIHSS评分显著低于对照组患者,差异有统计学意义(P<0. 05);治疗前,两组患者的血清NO、MDA、HMGB1水平差异无统计学意义(P>0. 05);治疗2周后,研究组患者的血清NO、MDA、HMGB1水平显著低于对照组患者,差异有统计学意义(P<0. 05);治疗前,两组患者的水肿面积、血肿量差异无统计学意义(P>0. 05);治疗2周后,研究组患者的水肿面积、血肿量显著低于对照组患者,差异有统计学意义(P<0. 05);治疗前,两组患者的双侧脑血流临界压力、外周阻力、平均血流速度、血流量差异无统计学意义(P>0. 05);治疗2周后,研究组患者的血流临界压力、外周阻力著低于对照组患者,平均血流速度、血流量显著高于对照组,差异有统计学意义(P<0. 05)。结论依达拉奉联合尼莫地平治疗HICH患者能进一步改善患者的脑血流参数、降低血清NO、MDA、HMGB1水平、改善患者的神经功能。
Objective To investigate the effect of edaravone combined with nimodipine on cerebral hemodynamics,serum nitric oxide( NO),malondialdehyde( MDA) and high mobility group protein 1( HMGB1) in patients with hypertensive cerebral hemorrhage( HICH).Methods 108 cases of patients with HICH were collected from April 2016 to May 2016 in our hospital,of which 54 cases were given basic treatment of adr mentioned++nim horizon( team),and the other 54 cases were treated by basic treatment+nim horizon( control group).The two groups of patients were compared before and after treatment of nerve function defect score( NIHSS),serum levels of NO,MDA,HMGB1,edema area,amount of hematoma,cerebral hemodynamic parameters.Results Before treatment,there was no statistically significant difference in NIHSS score between the two groups( P>0. 05).After 2 weeks of treatment,the NIHSS score of the patients in the study group was significantly lower than that of the patients in the control group,and the difference was statistically significant( P < 0. 05). Before treatment,there was NO statistically significant difference in serum NO,MDA,HMGB1 levels between the two groups( P > 0. 05). After 2 weeks of treatment,serum levels of NO,MDA and HMGB1 in the study group were significantly lower than those in the control group( P<0. 05).Before treatment,there was no statistically significant difference in edema area and hematoma volume between the two groups( P>0. 05).After 2 weeks of treatment,the edema area and hematoma volume in the study group were significantly lower than those in the control group( P<0. 05).Before treatment,there were no statistically significant differences in bilateral cerebral blood flow critical pressure,peripheral resistance,average blood flow velocity and blood flow between the two groups( P>0. 05).After 2 weeks of treatment,the critical blood flow pressure and peripheral resistance of patients in the study group were lower than those in the control group,and the average blood flow velocity and blood flow were significantly higher than those in the control group,with statistically significant differences( P<0. 05).Conclusion Edaravone combined with nimodipine in the treatment of HICH patients can further improve the cerebral blood flow parameters of patients,reduce the level of serum NO,MDA,HMGB1,and improve the neurological function of patients.
Objective To investigate the effect of edaravone combined with nimodipine on cerebral hemodynamics,serum nitric oxide( NO),malondialdehyde( MDA) and high mobility group protein 1( HMGB1) in patients with hypertensive cerebral hemorrhage( HICH).Methods 108 cases of patients with HICH were collected from April 2016 to May 2016 in our hospital,of which 54 cases were given basic treatment of adr mentioned++nim horizon( team),and the other 54 cases were treated by basic treatment+nim horizon( control group).The two groups of patients were compared before and after treatment of nerve function defect score( NIHSS),serum levels of NO,MDA,HMGB1,edema area,amount of hematoma,cerebral hemodynamic parameters.Results Before treatment,there was no statistically significant difference in NIHSS score between the two groups( P>0. 05).After 2 weeks of treatment,the NIHSS score of the patients in the study group was significantly lower than that of the patients in the control group,and the difference was statistically significant( P < 0. 05). Before treatment,there was NO statistically significant difference in serum NO,MDA,HMGB1 levels between the two groups( P > 0. 05). After 2 weeks of treatment,serum levels of NO,MDA and HMGB1 in the study group were significantly lower than those in the control group( P<0. 05).Before treatment,there was no statistically significant difference in edema area and hematoma volume between the two groups( P>0. 05).After 2 weeks of treatment,the edema area and hematoma volume in the study group were significantly lower than those in the control group( P<0. 05).Before treatment,there were no statistically significant differences in bilateral cerebral blood flow critical pressure,peripheral resistance,average blood flow velocity and blood flow between the two groups( P>0. 05).After 2 weeks of treatment,the critical blood flow pressure and peripheral resistance of patients in the study group were lower than those in the control group,and the average blood flow velocity and blood flow were significantly higher than those in the control group,with statistically significant differences( P<0. 05).Conclusion Edaravone combined with nimodipine in the treatment of HICH patients can further improve the cerebral blood flow parameters of patients,reduce the level of serum NO,MDA,HMGB1,and improve the neurological function of patients.
引文
[1]王希佳.依达拉奉联合尼莫地平治疗高血压脑出血对神经功能和血肿及水肿的影响[J].河北医药,2016,7(4):547-549.
[2]哈斯木江热合曼.尼莫地平联合依达拉奉对高血压脑出血病人脑血流动力学、氧化应激、VEGF、MAP水平的影响[J].中西医结合心脑血管病杂志,2017,15(16):2062-2065.
[3]龙勇,曾春,唐爽,等.高压氧联合药物治疗对高血压脑出血康复期脑血流特征、神经损伤程度及神经细胞因子的影响[J].海南医学院学报,2017,23(14):1995-1998.
[4]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.
[5] Inamasu J,Moriya S,Oheda M,et al.Role of catecholamines in acute hypertensive response:subarachnoid hemorrhage versus spontaneous intracerebral hemorrhage[J]. Blood Pressure Monitoring,2015,20(3):132-137.
[6]周文,董美华,孙西周,等.补阳还五汤配合西药分期治疗急性高血压脑出血的疗效观察[J].陕西中医,2016,37(8):971-973.
[7]赵显清,王红军,苟林,等.手术方式对高血压脑出血血清白细胞介素-6和肿瘤坏死因子-α的影响[J].中华实验外科杂志,2016,33(2):443.
[8]吴建龙,张艳利,乔建勇,等.高血压脑出血血肿周围脑组织中TNF-α、VEGF以及ET-1的表达及其意义[J].中华神经外科杂志,2017,33(5):498-501.
[9]徐占义,张亚召,赵旺淼,等.尼莫地平对高血压脑出血治疗的研究[J].检验医学与临床,2017,14(Z1):289-290.
[10]王经忠.尼莫地平联合依达拉奉治疗急性脑出血的疗效观察[J].中国实用神经疾病杂志,2016,19(17):117-119.
[11] Mohrien KM,Elijovich L,Venable GT,et al.Intensive blood pressure control during the hyperacute phase of intracerebral hemorrhage in patients at risk for resistant hypertension:A retrospective cohort study[J].Journal of critical care,2015,30(2):369-374.
[12]彭建红.瑞舒伐他汀对急性自发性脑出血患者脂质过氧化损伤的保护作用[J].中国现代医生,2017,55(5):29-32.
[13]杨静静.益母草碱对实验性脑缺血大鼠抗氧化损伤作用的影响[J].世界临床医学,2016,10(8):192-193.
[14]李新玲,黄怀宇,朱连海,等.急性幕上性脑出血患者脑水肿体积与高迁移率族蛋白B1的关系[J].卒中与神经疾病,2016,23(5):326-328.
[15]郭电渠,王新军,杨如意,等.癫痫患者血清HMGBI及其受体TLR4水平及临床意义分析[J].中华神经医学杂志,2016,15(9):936-940.
[2]哈斯木江热合曼.尼莫地平联合依达拉奉对高血压脑出血病人脑血流动力学、氧化应激、VEGF、MAP水平的影响[J].中西医结合心脑血管病杂志,2017,15(16):2062-2065.
[3]龙勇,曾春,唐爽,等.高压氧联合药物治疗对高血压脑出血康复期脑血流特征、神经损伤程度及神经细胞因子的影响[J].海南医学院学报,2017,23(14):1995-1998.
[4]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014)[J].中华神经科杂志,2015,48(6):435-444.
[5] Inamasu J,Moriya S,Oheda M,et al.Role of catecholamines in acute hypertensive response:subarachnoid hemorrhage versus spontaneous intracerebral hemorrhage[J]. Blood Pressure Monitoring,2015,20(3):132-137.
[6]周文,董美华,孙西周,等.补阳还五汤配合西药分期治疗急性高血压脑出血的疗效观察[J].陕西中医,2016,37(8):971-973.
[7]赵显清,王红军,苟林,等.手术方式对高血压脑出血血清白细胞介素-6和肿瘤坏死因子-α的影响[J].中华实验外科杂志,2016,33(2):443.
[8]吴建龙,张艳利,乔建勇,等.高血压脑出血血肿周围脑组织中TNF-α、VEGF以及ET-1的表达及其意义[J].中华神经外科杂志,2017,33(5):498-501.
[9]徐占义,张亚召,赵旺淼,等.尼莫地平对高血压脑出血治疗的研究[J].检验医学与临床,2017,14(Z1):289-290.
[10]王经忠.尼莫地平联合依达拉奉治疗急性脑出血的疗效观察[J].中国实用神经疾病杂志,2016,19(17):117-119.
[11] Mohrien KM,Elijovich L,Venable GT,et al.Intensive blood pressure control during the hyperacute phase of intracerebral hemorrhage in patients at risk for resistant hypertension:A retrospective cohort study[J].Journal of critical care,2015,30(2):369-374.
[12]彭建红.瑞舒伐他汀对急性自发性脑出血患者脂质过氧化损伤的保护作用[J].中国现代医生,2017,55(5):29-32.
[13]杨静静.益母草碱对实验性脑缺血大鼠抗氧化损伤作用的影响[J].世界临床医学,2016,10(8):192-193.
[14]李新玲,黄怀宇,朱连海,等.急性幕上性脑出血患者脑水肿体积与高迁移率族蛋白B1的关系[J].卒中与神经疾病,2016,23(5):326-328.
[15]郭电渠,王新军,杨如意,等.癫痫患者血清HMGBI及其受体TLR4水平及临床意义分析[J].中华神经医学杂志,2016,15(9):936-940.