参麦注射液治疗 tSAH后脑血管痉挛的临床研究及其对ET-1的影响

目的：探讨参麦注射液对外伤性蛛网膜下腔出血（tSAH）后脑血管痉挛（CVS）的治疗效果及其对血浆和脑脊液内皮素-1（ET-1）的影响。方法将合并tSAH的颅脑损伤患者63例按随机数字表法分为参麦组（33例）和对照组（30例）。参麦组在常规治疗基础上加用参麦注射液，对照组采用常规治疗。用放射免疫分析法分别测定血浆和脑脊液ET-1浓度，经颅多普勒超声连续检测伤后大脑中动脉血流速度（Vm）变化并评价CVS程度，记录6个月后GOS昏迷预后评分。结果参麦组患者血浆和脑脊液ET-1值在1周后较对照组显著降低（P＜0.01）；Vm在6天后较对照组显著降低（P＜0.01）；轻度CVS检出率显著低于对照组（P＜0.05）。结论参麦注射液可通过降低ET-1水平改善tSAH患者CVS状态，但不能改善患者最终预后。

Efficacy of Shenmai injection for cerebral vasospasm after traumatic subarachnoid hemorrhage and its ralation to ET-1 levels in plasma and cerebrospinal fluid

Objective To investigate of Shenmai injection for cerebral vasospasm （CVS） after traumatic subarachnoid hemorrhage （tSAH） and its relation to ET- 1 levels in plasma and cerebrospinal fluid （CSF）. Methods Sixty three tSAH patients were randomly assigned to receive conventional treatment and Shenmai injection（Shenmai group, n=33） or conventional treatment only （control group, n=30）. The levels of plasma and CSF ET- 1 were measured by raidoimmunoassay. Mean middle cerebral artery flow velocity（Vm） was detected by transcranial Doppler and the Glasgow Outcome Score （GOS） at 6 month after treatment was recorded. Results The levels of plasma and CSF ET- 1 in Shenmai group were significantly lower than those control group after one week （P〈0.01）. Vm in Shenmai group was significantly slower than that in control group after 6 days （P〈0.01）. The de-tection rate of mild CVS in Shenmai group was significantly lower than that in control group（P〈0.05）. Conclusion Shenmai injec-tion can improve cerebral vasospasm status in patients with tSAH, which is associated with the reduction of ET- 1 levels in plasma and CSF.