腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效及对血清sICAM-1、FABP、MCP-1水平和脑积水形成的影响

目的:分析腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效及对血清可溶性细胞间黏附分子-1(sICAM-1)、脂肪酸结合蛋白质(FABP)、核细胞趋化蛋白(MCP-1)水平和脑积水形成的影响。方法:选择我院2016年3月~2018年3月收治的112例动脉瘤性蛛网膜下腔出血患者,按随机数字表法分为对照组(n=48)和研究组(n=64)。对照组采用腰大池引流治疗,研究组基于对照组联合法舒地尔治疗。比较两组临床疗效,治疗前后血清sICAM-1、FABP、MCP-1水平、血压、大脑中动脉血流参数水平和神经功能的变化,脑积水发生率及不良反应发生情况。结果:治疗后,研究组总有效率显著高于对照组(89.02%vs.72.91%,P<0.05)。两组治疗后血清sICAM-1、FABP、MCP-1、血压、大脑中动脉血流参数水平和神经功能缺损评分量表(NIHSS)均较治疗前下降,格拉斯哥昏迷评分(GCS)均较治疗前上升,研究组以上指标较对照组改变更明显(均P<0.05)。两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论:腰大池引流联合法舒地尔治疗动脉瘤性蛛网膜下腔出血的疗效明显优于单用腰大池引流治疗,其可显著降低血清sICAM-1、FABP、MCP-1水平,降低脑积水发生率,改善患者预后。

Curative Efficacy of Lumbar Cistern Drainage Combined with Fasudil in the Treatment of Aneurysmal Subarachnoid Hemorrhage and Its Effect on the Serum Levels of sICAM-1, FABP, MCP-1 and Hydrocephalus Formation

ABSTRACT Objective: To analyze the curative effect of lumbar cistern drainage combined with fasudil in the treatment of aneurysmal subarachnoid hemorrhage and the effect of serum levels of soluble intercellular adhesion molecle-1 (sICAM-1), fatty acid binding protein (FABP), nuclear chemokine protein (MCP-1) and hydrocephalus. Methods: 112 cases of patients with aneurysmal subarachnoid hemorrhage who treated from March 2016 to March 2018 in our hospital, according to random number table method those patients were divided into the control group (n=48) and research group (n=64), the control group was treated with lumbar cistern drainage, the research group was treated with fasudil based on the control group, then clinical curative effect, changes in serum levels of sICAM-1, FABP, MCP-1, blood pressure, blood flow parameters in the middle cerebral artery, and neurological function before and after treatment, and the incidence of hydrocephalus, adverse reactions occur in both group were compared. Results: After treatment, total effective rate of the research group was significant higher than that of the control group(89.02% vs. 72.91%, P<0.05). The levels of sICAM-1, FABP, MCP-1, blood pressure, blood flow parameters of the middle cerebral artery, and the score scale for neurological impairment (NIHSS) in the two groups all decreased after treatment, and the Glasgow coma score (GCS) increased after treatment. The above indexes in the research group were more significantly changed than those in the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The efficacy of lumbar cistern drainage combined with fasudil in the treatment of aneurysmal subarachnoid hemorrhage is definitely better than that of lumbar cistern drainage alone, which can significantly reduce the levels of sICAM-1, FABP, MCP-1, the incidence of hydrocephalus, and improve the prognosis of patients.