摘要
目的探讨颅内动脉瘤并心肌损伤机制,寻找防治方法。方法 59例颅内动脉瘤蛛网膜下腔出血并心肌损伤患者,分为实验组、对照组,颅内动脉瘤蛛网膜下腔出血无心肌损伤患者为空白对照组,实验组在手术治疗基础上应用右美托咪定抗交感活性,对照组及空白对照组采用手术及常规治疗。实验前、后1,3,5,7 d动态测定血浆去甲肾上腺素(norepinephrine,NE)、肾上腺素(epinephrine,E)及脑型利钠肽(Brain Natriuretic Peptides,BNP)浓度。结果与空白对照组比较,颅内动脉瘤合并心肌损伤者,血浆平均NE(4.82±0.41 vs 2.90±0.59,P<0.05)、E(4.26±0.71 vs 2.87±0.57,P<0.05)浓度、BNP(5329.69±61.48 vs 1101.84±52.19,P<0.05)均明显升高,右美托咪定干预治疗后,实验组术后1 d NE、E、BNP开始下降,3～5 d恢复正常,对照组术后3 d,NE、E、BNP开始下降,5 d恢复正常,空白对照组则无变化。结论颅内动脉瘤并蛛网膜下腔出血合并心肌损伤与体内交感活性亢进有关,行抗交感治疗可改善心肌损伤。
Objective To investigate the injury mechanism and the therapeutic method of myocardial injury with Intracranial aneurysms.Methods 59 cases were divided into experimental group and control group.Intracranial aneurysm without myocardial damage in patients with subarachnoid hemorrhage as the placebo-treated group.Anti-sympathetic activity with Dexmedetomidine Hydrochloride was given on the basis of surgical therapy in the experimental group.The control group and the placebo-treated group took the operation and conventional therapy.The concentration of norepinephrine（NE）,epinephrine（E） and Brain Natriuretic Peptides（BNP） was detected before and after 1,3,5,7 days in the experiment.Results Compared with the placebo-treated group,the concentration of（NE 4.82±0.41vs 2.90±0.59,P0.05）,E（4.26±0.71vs 2.87±0.57,P0.05）、BNP（5329.69±61.48 vs 1101.84±52.19,P0.05） raised obviously.NE and E began to decrease at the postoperation 1and 3 days after anti-sympathetic activity with Dexmedetomidine Hydrochloride,and recovered after 3 and 5 days in the experimental group and control group.There was no change in the placebo-treated group.Conclusion The pathomechanism of Intracranial aneurysms with subarachnoid hemorrhage was concerned with sympathetic nerve activity.Anti-sympathetic treatment could improve myocardial injury.
出处
《中华全科医学》
2013年第3期409-411,共3页
Chinese Journal of General Practice
关键词
颅内动脉瘤
心肌损伤
防治
Intracranial aneurysms
Myocardial injury
Prevention and treatment
