摘要
目的 探究乌拉地尔联合尼莫地平在老年高血压脑出血(hypertensive intracerebral hemorrhage, HICH)治疗中的效果。方法 选取2022年3月至2024年3月河南省南阳医学高等专科学校第一附属医院收治的老年HICH患者128例,采用随机数表法分为单一组64例和联合组64例。2组均接受常规治疗,单一组同时给予乌拉地尔治疗,联合组同时给予乌拉地尔联合尼莫地平治疗。比较2组临床疗效、临床指标(脑血肿体积、颅内压)、神经功能[脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)、神经元特异性烯醇化酶(neuron-specific enolase, NSE)、神经生长因子(nerve growth factor, NGF)]、血流动力学[血流灌注指数(perfusion index, PI)、脑血管储备能力(cerebrovascular reserve, CVR)、双侧动脉平均流速]、血管内皮功能[血管内皮细胞生长因子(vascular endothelial growth factor, VEGF)、内皮素1(endothelin, ET-1)、血管生成素1(angiopoietin-1,Ang-1)],统计治疗期间不良反应发生情况。结果 联合组总有效率显著高于单一组(89.06%vs 75.00%,P<0.05)。2组治疗后颅内压、脑血肿体积、PI、NSE、VEGF、ET-1、Ang-1显著低于治疗前(P<0.05),且联合组显著低于单一组(P<0.01)。2组治疗后CVR、双侧动脉平均流速、BDNF、NGF水平显著高于治疗前(P<0.05),且联合组显著高于单一组(P<0.01)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 乌拉地尔联合尼莫地平可缩小老年HICH患者脑血肿体积,降低颅内压,改善神经功能、血流动力学和血管内皮功能,且不增加不良反应。
Objective To explore the effect of urapidil combined with nimodipine in the treatment of elderly hypertensive intracerebral hemorrhage(HICH).Methods A total of 128 elderly HICH patients admitted in our hospital from March 2022 to March 2024 were recruited and randomly divided into single group(64 cases)and combined group(64 cases).Both groups received routine treatment,and the single group was treated with urapidil while the combined group was given urapidil combined with nimodipine.Clinical efficacy,clinical indicators[cerebral hematoma volume,intracranial pressure(ICP)],neurological function indicators[brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),nerve growth factor(NGF)],hemodynamic pa-rameters[perfusion index(PI),cerebrovascular reserve capacity(CVR),mean bilateral arterial flow velocity],and vascular endothelial function indicators[vascular endothelial growth factor(VEGF),endothelin-1(ET-1),angiopoietin-1(Ang-1)]were compared between the two groups.The incidence of adverse reactions was observed during treatment.Results The total effective rate was significantly higher in the combined group than the single group(89.06% vs 75.00%,P<0.05).After treatment,the ICP,hematoma volume,PI,and levels of NSE,VEGF,ET-1 and Ang-1 in both groups were significantly lower than those before treatment(P<0.05).These indi-cators in the combined group were significantly lower than those in the single group(P<0.05,P<0.01).The CVR,mean bilateral arterial flow velocity,and BDNF and NGF levels were notably increased in both groups after treatment,and the indicators were significantly higher in the combined group than the other group(P<0.05,P<0.01).There was no statistical difference in the incidence of adverse reactions between groups(P>0.05).Conclusion Urapidil combined with ni-modipine can shrink the volume of cerebral hematoma,reduce ICP,and improve neurological function,hemodynamics and vascular endothelial function in elderly HICH patients,and the treat-ment does not increase the incidence of adverse reactions.
作者
闫萍
马金玉
胡成旺
牛鑫
刘朋
Yan Ping;Ma Jinyu;Hu Chengwang;Niu Xin;Liu Peng(Department of Neurology,First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China)
出处
《中华老年心脑血管病杂志》
北大核心
2025年第6期762-765,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
南阳市软科学研究计划项目(RKX085)。
关键词
尼莫地平
高血压
脑出血
血流动力学
nimodipine
hypertension
cerebral hemorrhage
hemodynamics
