摘要
目的观察葛根素对动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛(CVS)相关血管活性因子的影响及其疗效,初步探讨其可能的作用机制。方法选择aSAH患者54例,随机抽签分为治疗组30例、对照组24例,两组均常规治疗,治疗组加用葛根素0.5g加入葡萄糖注射液250mL,静脉滴注,每天1次,从病程第3天开始使用,连用2周。比较两组治疗前后血浆一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)、血栓素B2(thromboxane B2,TXB2)、6-酮-前列腺素1α(6-keto-prostaglandin F1α,6-K-PGF1α)水平,观察经颅超生彩色多普勒(transcranial Doppler,TCD)、CVS的发生率并比较两组出院时Glasgow预后评分(Glasgow outcome scale,GOS)。结果与对照组比较,治疗组用药后血浆NO、ET-1、6-K-PGF1α水平升高(P<0.05)、TXB2水平下降(P<0.05)、CVS的发生率降低(P<0.05)、大脑中动脉(MCA)平均血流速度升高(P<0.05)及出院时GOS评分升高(P<0.05)。结论葛根素是一种防治aSAH后CVS的有效药物,并能改善患者的近期预后,其机理可能与改善血管内皮活性因子的水平,即升高血浆NO、前列环素(PGI2)含量,降低血栓素A(TXA2)含量从而扩张脑血管,同时增加脑血流量,改善脑灌注等有关。
Objective To investigate the effects and possible mechanisms of puerarin on the vascular active factors correlated to cerebral vasospasm（CVS） after aneurysm subarachnoid hemorrhage（aSAH）.Methods Fifty-four patients with aSAH were randomly assigned to the puerarin group（30 cases） and the control group（24 cases） by lot.On the basis of routine treatment,the patients in the pueparin group were intravenously dripped with 0.5 g puerarin by adding in 250 mL glucose injection once daily.The injection was given starting from the 3rd day of the disease course,for 14 successive days.The plasma levels of nitric oxide（NO）,endothelin-1（ET-1）,thromboxane B2（TXB2）,6-Keto-prostaglandin F1α（6-K-PGF1α） were compared between the two groups pre-and post-therapy.The incidence of cerebral vasospasm（CVS） was observed using transcranial Doppler（TCD）.The Glasgow outcome scale（GOS） were compared at discharge between the two groups.Results Compared with the control group,the plasma levels of NO,ET-1,and 6-K-PGF1α increased in the puerarin group（P0.05）,the TXB2 level decreased（P0.05）,the incidence of CVS decreased（P0.05）,the mean MCA velocity increased（P0.05）,and the GOS at discharge increased（P0.05）.Conclusions Puerarin is an effective agent for the prophylaxis and treatment of the CVS in patients after aSAH.Moreover,it can improve the prognosis.The mechanism might be correlated with improving the levels of the vascular active factors,i.e.,increasing the plasma levels of NO and PGI2,decreasing TXA2 in plasma,increasing the cerebral blood flow,and improving cerebral perfusion.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2012年第2期164-167,共4页
Chinese Journal of Integrated Traditional and Western Medicine
基金
江苏省中医药管理局资助课题(No.LZ09041)
