摘要
目的探讨复方麝香联合尼莫地平配合微创手术治疗高血压脑出血的疗效及对血清炎性反应、应激、凋亡指标的影响。方法采用前瞻性研究的方法。收集2017年3月至2021年1月在黑龙江中医药大学附属第一医院住院接受治疗的118例高血压脑出血患者,按随机数字表法分为对照组、复方麝香组各59例。对照组患者微创手术后,在常规治疗基础上给予尼莫地平治疗,复方麝香组患者在对照组基础上加入复方麝香治疗,持续2周后评估疗效并测定血清炎性指标、氧化应激指标、凋亡指标的水平。结果复方麝香组患者的总有效率高于对照组[98.3%(58/59)比88.1%(52/59)],差异有统计学意义(P<0.05)。两组经过2周治疗后,血清中炎性指标[核转录因子κB(NF-κB)、白细胞介素-1β(IL-1β)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)]、凋亡指标[可溶性细胞凋亡因子Fas(sFas)、可溶性细胞凋亡因子Fas受体(sFas-L)]、氧化应激指标[晚期蛋白氧化产物(AOPP)、丙二醛(MDA)]有所下降,部分氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)]升高,且复方麝香组患者血清中上述炎性指标、凋亡指标、氧化应激指标水平均低于对照组[NF-κB:(18.96±2.17)ng/L比(24.10±3.23)ng/L,IL-1β:(12.88±1.74)ng/L比(15.19±1.63)ng/L,MMP-3:(5.62±0.95)ng/L比(7.97±0.86)ng/L,MMP-9:(7.07±0.86)ng/L比(9.26±1.13)ng/L,sFas:(3.24±0.38)μg/L比(4.19±0.53)μg/L,sFas-L:(209.17±24.39)ng/L比(288.54±37.61)ng/L,AOPP:(10.76±1.84)μg/L比(13.51±2.09)μg/L,MDA:(2.87±0.32)μmol/L比(3.45±0.34)μmol/L],差异均有统计学意义(P<0.05),上述部分氧化应激指标高于对照组患者[GSH-Px:(3274.91±376.09)U/L比(2854.19±325.22)U/L,CAT:(60.82±7.43)U/L比(52.17±6.48)U/L],差异有统计学意义(P<0.05);治疗期间两组患者皮疹、腹泻、药物性肝脏和心肌损伤的发生率比较差异无统计学意义(P>0.05)。结论复方麝香用于高血压脑出�
Objective To investigate the efficacy of Compound Musk combined with nimodipine combined with minimally invasive surgery in the treatment of hypertensive cerebral hemorrhage and the effects on serum inflammation,stress and apoptosis.Methods Prospective research methods was used.A total of 118 patients with hypertensive intracerebral hemorrhage who received treatment in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from March 2017 to January 2021 were randomly divided into control group and Compound Musk group(59 cases in each group).After minimally invasive surgery,patients in the control group were treated with nimodipine on the basis of conventional treatment,while patients in the Compound Musk group were treated with compound musk on the basis of the control group.After 2 weeks,the efficacy was evaluated and the levels of serum inflammatory indexes,oxidative stress indexes and apoptosis indexes were measured.Results The total effective rate in Compound Musk group was higher than that in control group:98.3%(58/59)vs.88.1%(52/59),and the difference was statistically significant(P<0.05).After 2 weeks of treatment,serum inflammatory indexes including nuclear factor-κB(NF-κB),interleukin-1β(IL-1β),matrix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9);apoptosis indexes including soluble Fas receptor(sFas),soluble Fas ligand(sFAS-L);oxidative stress indexes including advanced oxidation protein products(AOPP),malondialdehyde(MDA)decreased,and some oxidative stress indexes including glutathione peroxidase(GSH-Px),catalase(CAT)increased.The levels of the above inflammatory indexes,apoptosis indexes and oxidative stress indexes in Compound Musk group were lower than those in control group,NF-κB:(18.96±2.17)ng/L vs.(24.10±3.23)ng/L,IL-1β:(12.88±1.74)ng/L vs.(15.19±1.63)ng/L,MMP-3:(5.62±0.95)ng/L vs.(7.97±0.86)ng/L,MMP-9:(7.07±0.86)ng/L vs.(9.26±1.13)ng/L,sFas:(3.24±0.38)μg/L vs.(4.19±0.53)μg/L,sFas-L:(209.17±24.39)ng/L vs.(288.54±37.61)ng/L,AOPP:
作者
杨宝义
叶向梅
王建伟
夏士涛
Yang Baoyi;Ye Xiangmei;Wang Jianwei;Xia Shitao(The Third Department of Surgery,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Hematological Oncology Center,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《中国医师进修杂志》
2023年第3期199-204,共6页
Chinese Journal of Postgraduates of Medicine
基金
黑龙江省自然科学基金联合引导项目(LH2019H110)
黑龙江省省属高等学校基本科研业务费科研项目(13031170023)
黑龙江中医药大学科研基金项目(201702)。
关键词
颅内出血
高血压性
尼莫地平
发炎
炎症
复方麝香
凋亡
Intracranial hemorrhage,hypertensive
Nimodipine
Inflammation
Compound Musk
Apoptosis
