摘要
目的研究盐酸甲氯芬酯联合七叶皂苷钠对急性脑出血患者脑水肿体积以及细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)、基质金属蛋白酶-2(matrixmetalloproteinase-2,MMP-2)、MMP-9、神经元特异性烯醇化酶(neuron specific enolase,NSE)水平的影响。方法选取2020年1月至2022年3月湖南省郴州市第一人民医院收治的278例急性脑出血患者为研究对象,采用随机数字表法分为对照组和观察组,每组139例。对照组给予盐酸甲氯芬酯治疗,观察组在对照组的基础上联合七叶皂苷钠治疗,两组患者均连续治疗14d。比较分析两组患者治疗前后的脑水肿体积、血清学指标、神经功能和日常生活活动能力。比较分析两组患者治疗后的临床疗效和不良反应发生情况。结果与治疗前比较,两组患者治疗后的脑水肿绝对体积、相对体积、ICAM-1、MMP-2、MMP-9、NSE以及美国国立卫生院卒中量表评分均显著减小或降低(P<0.05),且观察组显著小于或低于对照组(P<0.05)。与治疗前比较,两组患者治疗后的格拉斯哥昏迷量表评分、Barthel指数均显著升高(P<0.05),且观察组显著高于对照组(P<0.05)。治疗后,观察组患者的总有效率显著高于对照组(P<0.05)。两组患者治疗后的不良反应发生率比较差异无显著性(P>0.05)。结论盐酸甲氯芬酯联合七叶皂苷钠治疗急性脑出血患者的临床疗效显著,可有效缩小脑水肿体积,降低ICAM-1、MMP-2、MMP-9和NSE水平,改善患者的神经功能与日常生活活动能力,且安全性较好。
Objective To study the effects of meclofenoxate hydrochloride combined with sodium aescinate on cerebral edema volume and levels of intercellular adhesion molecule-1(ICAM-1),matrix metalloproteinase-2(MMP-2),MMP-9 and neuron specific enolase(NSE)in patients with acute cerebral hemorrhage.Method 278 patients with acute cerebral hemorrhage admitted to Chenzhou First People’s Hospital of Hunan Province from January 2020 to March 2022 were selected as the study subjects.They were divided into control group and observation group by random number table method,with 139 cases in each group.The control group was treated with meclofenoxate hydrochloride while the observation group was combined with sodium aescinate on the basis of the control group.Both groups were treated continuously for 14 days.The cerebral edema volume,serological index,neurological function and ability of daily living before and after treatment were compared between the two groups.The clinical efficacy and the occurrence of adverse reactions after treatment were compared between the two groups.Result Compared with before treatment,the absolute volume,relative volume,ICAM-1,MMP-2,MMP-9,NSE and NIHSS in two groups after treatment were significantly decreased(P<0.05),and the observation group was significantly lower than the control group(P<0.05).Compared with before treatment,GCS score and BI in two groups after treatment were significantly increased(P<0.05),and observation group was significantly higher than control group(P<0.05).After treatment,the total effective rate of observation group was significantly higher than that of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups after treatment(P>0.05).Conclusion Meclofenoxate hydrochloride combined with sodium aescinate has significant clinical efficacy in the treatment of patients with acute cerebral hemorrhage,which can effectively reduce the volume of cerebral edema,reduce the levels of ICAM-1,MMP-2,MMP-9 and NSE,improve the neuro
作者
谭智灵
唐国强
方松
谭文艳
Tan Zhiling;Tang Guoqiang;Fang Song;Tan Wenyan(Department of Neurosurgery,Chenzhou First People’s Hospital of Hunan Province,Hunan Chenzhou 423000,China;Department of Emergency Office,Chenzhou Center for Disease Control and Prevention of Hunan Province,Hunan Chenzhou 423000,China)
出处
《中国医刊》
CAS
2023年第5期509-512,共4页
Chinese Journal of Medicine
基金
湖南省郴州市科学技术局科学发展计划项目(ZDYF2020109)。
关键词
盐酸甲氯芬酯
七叶皂苷钠
急性脑出血
脑水肿体积
Meclofenoxate hydrochloride
Sodium aescinate
Acute cerebral hemorrhage
Cerebral edema volume
