动脉瘤性SAH后症状性脑血管痉挛与高凝状态相关性及防治研究

目的:探讨动脉瘤性SAH后症状性脑血管痉挛与病人外周血清高凝状态的相关性,同时观察应用丹参注射液对血液高凝状态的影响。方法:60例动脉瘤性蛛网膜下腔出血(SAH)病人,出现症状性脑血管痉挛38例,症状性脑血管痉挛组随机分为丹参治疗组和非丹参治疗组。所有病人分别在住院时、3天、7天、14天、21天,进行周围血中FDP和D-dimer含量的测定并进行动态观察。结果:症状性脑血管痉挛组病人FDP和D-dimer的含量在住院后各时间段明显高于非症状性脑血管痉挛组(P<0.01),住院后第14天、21天丹参治疗组FDP和D-dimer的含量明显低于非丹参治疗组(P<0.05)。症状性脑血管痉挛组中,丹参治疗组病人的预后明显优于非丹参治疗组。结论:动脉瘤性SAH引起症状性脑血管痉挛与血粘稠度增高有明显关系。丹参注射液可明显降低血粘稠度,促进脑血液循环对改善症状性脑血管痉挛的脑缺血症状有明显的治疗作用。

The relationship between Symptomatic Cerebral vasospasm and high coagulation state following aneurysmal SAH and its prophylactic study

Objective: The study investigate relation between blood paste degree and symptomatic cerebral va-sospasm accroding to measure blood coaulation factor in periperal blood, observ effect of Dan Shen Solution parenteral solution therapy high coagulate state. Method: The study includes 60 cases of SAH patients. 38 case progress to symptomatic cerebral vasospasm, and which inculde Dan shen treatment sub-group and non-Danshen treatment sub-group. All patients are measure FDP and D-dime in periphery blood and MRA and/or DSA at the time be in hospital、pre-oper-ation、 3 days、7 days、14days、 21days. Result: the study show the content of FDP and D-dimer of symptomatic cerebral vasospasm group patients are obviously higer than non-symptomatic cerebral vasospasm group (P<0. 01), bu the content of FDP and D-dimer of non-Danshen treatment group is highter significant than Dan shen treatment group on the 14th day and the 21st day after hospitalized (P<0.05). The outcome of patients are better than non-Danshen treatment group's in Danshen treatment group. Conclusion: There is significant relationship between symptomatic vasospastic due to aneurysmatic SAH and high coagulate state of periphery blood. Dan Shen Soluation-tradition Chinese traditional medicine have many roles include reducing blood paste degree, accelerate brain blood circle and improve cerebral vasospasm, especially improve obviously brain lack-blood.