Rho激酶抑制剂在外伤性蛛网膜下腔出血后脑血管痉挛的疗效研究

目的探讨Rho激酶抑制剂对外伤性蛛网膜下腔出血（tSAH）脑血管痉挛（CVS）的治疗效果。方法58例tSAH患者随机分为常规治疗组和Rho激酶抑制剂组,采用临床症状改善情况及经颅彩色多普勒超声诊断仪（TCD）探测治疗前、治疗后（3d、5d、12d）大脑中动脉血流（MCA）速度变化来分析判断Rho激酶抑制剂对tSAH后CVS的治疗效果。结果Rho激酶抑制剂组临床症状、体征改善有效率81．16％,对照组41．69％。两组治疗前TCD检查MCA均轻度升高。Rho激酶抑制剂组治疗后（3、5、12d）MCA峰值低于常规治疗组（P〈0．05）。结论Rho激酶抑制剂能明显缓解tSAH后延迟性CVS的发生,改善临床症状。TCD对外伤性蛛网膜下腔出血的早期诊断、监测CVS的发生有实用价值。Rho激酶抑制剂为临床神经外科防止tSAH后CVS提供一个新的治疗方法及依据。

Clinical study of rho-kinase inhibitor therapy on cerebral vasospasm following traumatic subarachnoid hemorrhage

Objective To investigate the curative effects of application of Rho-kinase inhibitor cerebral vasospasm following traumatic subarachnoid hemorrhage in patients. Methods 58 patients of traumatic subarachnoid hemorrhage were divided randomly into control group and Rho-kinase inhibitor therapy group. To investigate the variability of clinical feature , the probe of TCD was applied to detect the velocity of middle cerebral artery （before, 3 d, 5 d, 12 d ）. Results The clinical response rate in the Rho-I group and control group were 81.16% and 41.69% respectively. After therapy, the flow rate of cerebral vasoconstriction in middle cerebral artery were also lower in Rho-I group patients than in control group patients （P 〈 0. 05 ） Conclusion Rho-kinase inhibiting therapy can significantly alleviate cerebral vasospasm following tSAH. TCD may provide evidence for the treatment and prevention of CVS.