尼莫地平联合胸腺五肽治疗脑出血后缺血性脑损伤效果及其对血清TLR4、RBP4水平的影响

    Effect of the nimodipine combined with thymopentin in the treatment of HIBD, after intracerebral hemorrhage and its effects on serum levels of TLR4 and RBP4

    • 摘要:
      目的探讨尼莫地平联合胸腺五肽治疗脑出血后缺血性脑损伤效果及其对病人血清Toll样受体4(TLR4)、视黄醇结合蛋白4(RBP4)水平的影响。
      方法选取脑出血后缺血性脑损伤病人78例,随机分为观察组和对照组,各39例。对照组给予尼莫地平,观察组给予尼莫地平联合胸腺五肽进行治疗。比较2组病人治疗前和治疗后第15天的脑水肿体积、颅内压、美国国立卫生研究院卒中量表评分、Barthel指数和脑血流动力学指标及血清TLR4、RBP4水平。
      结果治疗后,2组病人脑水肿体积、美国国立卫生研究院卒中量表评分、Barthel指数、颅内压水平和血清TLR4、RBP4水平均较治疗前明显改善(P < 0.05~P < 0.01),且观察组病人以上指标均优于对照组(P < 0.05~P < 0.01)。治疗后,观察组病人血流动力学指标亦较治疗前明显改善(P < 0.01),对照组病人治疗前后血流动力学指标差异无统计学意义(P>0.05)。
      结论尼莫地平联合胸腺五肽对于脑出血后缺血性脑损伤病人具有较好治疗效果,并降低病人血清TLR4、RBP4水平,值得临床应用。

       

      Abstract:
      ObjectiveTo observe the effects of the nimodipine combined with thymopentin in the treatment of hypoxic-ischemic brain damage(HIBD)after intracerebral hemorrhage, and its effect on serum levels of Toll-like receptor 4(TLR4)and retinol binding protein 4(RBP4).
      MethodsSeventy-eight patients with HIBD after intra cerebral hemorrhage were randomly divided into the observation group and control group(39 cases in each group).The control group was treated with nimodipine, and the observation group was treated with nimodipine combined with thymopentin.The cerebral edema volume, intracranial pressure, national institutes of health stroke scale(NIHSS) score, Barthel index and cerebral hemodynamic index, and serum levels of TLR4 and RBP4 bewteen two groups were compared before and after 15 days of treatment.
      ResultsCompared with before treatment, the cerebral edema volume, NIHSS score, Barthel index, intracranial pressure, and serum levels of TLR4 and RBP4 in two groups were significantly improved after treatment(P < 0.05 to P < 0.01), and the above indexes in observation group were better than that in control group(P < 0.05 to P < 0.01).After treatment, the hemodynamic indexes in observation group were significantly improved compared with those before treatment(P < 0.01), and the difference of the hemodynamic indexes in control group were not statistically significant between before and after treatment(P>0.05).
      ConclusionsThe nimodipine combined with thymopentin in the treatment of HIBD after intracerebral hemorrhage has good therapeutic effects, and can reduce the serum levels of TLR4 and RBP4, which is worthy of promotion.

       

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