依达拉奉防治蛛网膜下腔出血后迟发性脑血管痉挛的疗效观察

目的观察自由基清除剂依达拉奉对动脉瘤性蛛网膜下腔出血（aneurysmal subarachoid hemorrhage，aSAH）后迟发性脑血管痉挛（delayed cerebrovascular spasm，DCVS）的防治作用。方法58例aSAH患者随机分成两组，对照组（n=29）：常规治疗加尼莫地平1～2mg／h持续泵入连用14天。治疗组（n=29）：在对照组治疗基础上同时应用依达拉奉30mg入液静脉滴注，2次／d，连用14天。所有患者于治疗后第1、3、7、14天检测血清中s-100B蛋白浓度。经颅多普勒（TCD）检测大脑中动脉（MCA）血流速度。比较治疗前后两组预后评分并进行统计学分析。结果总体病情格拉斯哥昏迷评分（GCS）、Hunt—Hess分级及Fisher分级治疗前两组差异无统计学意义（P〉0．05）。两组的MCA血流速度和s—100B含量在纽间、不同时点以及在纽间和不同时点的交互作用中差异均有统计学意义（P=0．000），两组MCA血流速度在第7天最快、S-100B含量在第7天最高，均到第14天下降，治疗组总的趋势低于对照组。治疗组的临床疗效优于对照组（P=0．031）。结论依达拉奉可有效的降低氧自由基水平，缓解迟发性脑血管痉挛。

Therapeutic effects of edaravone for delayed cerebrovascular vaspasm after subarachnoid hemorrhage

Objective To evaluate the effects of treatment with edaravone,as a hydroxyl free radical scavenger, for delayed cerebrovascular spasm（DCVS） after aneurysmal subarachoid hemorrhage（aSAH）. Methods Fifty＇eight cases with aSAH were randomly divided into therapeutic group（ n=29） and control group （ n =29）. All patients were given the same treatment, but the dose of edaravone 30 mg twice a day for 14 days was given to the patients in therapeutic group. The serum level of S-100B was measured at the 1,3,7,14 day of treatment. The velocity of blood flow in MCA was detected by TCD. Comparisons of manifestation and prognosis scores between pre-and post-therapy in two groups were done with statistical analysis. Results There were no siginificant difference grades of Glasgow Coma Scale（GCS）, Hunt ＆ Hess,Fisher pre-and post-therapy between two groups（ P〉0.05）. The velocity of MCA blood flow and the serum level of SB-100 were significant difference at different time points between two groups （P = 0. 000）. The peak value were both on 7th day,and declined on the 14th day. The value was always lower in therapeutic group than in control group at same time points. Curative effect：the clinical effect was better in therapeutic group than in control group（ P =0. 000）. Conclusion Edaravone has effects to drop the level of hydroxyl free radical scavenger and alleviates DCVS.