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目的:探讨蛛网膜下隙出血(SAH)后血浆NO、ET含量变化及抗纤维蛋白溶解药氨甲苯酸和钙拮抗剂尼莫地平对其影响。方法:对120例SAH进行病情评估,随机分为:常规治疗组40例:给予镇静、止痛、脱水脑保护、补液等常规处理;氨甲苯酸(止血芳酸)组40例:在常规治疗基础上,加氨甲苯酸0.2 g,静脉点滴,每日2次,共14 d;尼莫地平组40例:常规治疗加尼莫地平10 mg,静脉点滴,每日1次,共14 d。3组病人分别在发病后247、2 h,71、4、30 d清晨抽取静脉血,检验血浆NO、ET含量;并进行临床预后评估。结果:SAH后血浆NO、ET含量显著升高;氨甲苯酸和尼莫地平组治疗后前者ET含量较常规治疗组明显增高、NO含量无明显变化。结论:NO、ET参与并影响了SAH后复杂的病理生理过程;抗纤维蛋白溶解药和钙拮抗剂部分通过影响ET含量而发挥作用。
Objective: To investigate the changes of plasma NO and ET levels after subarachnoid hemorrhage (SAH) and the effects of antifibrinolytic drugs aminomethylbenzoate and nimodipine on them. Methods: A total of 120 patients with SAH were randomly divided into four groups: conventional treatment group (n = 40), conventional treatment of sedation, analgesia, dehydration brain protection and rehydration; methotrexate Add 0.2 g of methotrexate, intravenous drip, twice a day for 14 days; nimodipine group 40 patients: routine treatment of nimodipine 10 mg, intravenous drip once daily for 14 days. Venous blood samples were taken from the three groups at 247, 2 h, 71, 4, 30 d after the onset of illness respectively to test the plasma NO and ET levels. The clinical prognosis was evaluated. Results: After SAH, plasma NO and ET contents increased significantly. Compared with conventional treatment group, the content of ET in the group treated with trimethoprim and nimodipine was significantly higher than that in the control group, but the NO content did not change significantly. CONCLUSION: NO and ET participate in and affect the complex pathophysiological processes after SAH. Anti-fibrinolytic agents and calcium antagonists partially affect ET content.