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目的 :探讨七叶皂苷钠治疗蛛网膜下隙出血 (SAH)的作用机制。方法 :将 47例SAH病人随机分为七叶皂苷钠治疗组 (治疗组 )和非七叶皂苷钠治疗组 (非治疗组 ) ,观察两组病人治疗前后病情、CT分级、脑脊液压力及血浆超氧化物歧化酶 (SOD)总活力和丙二醛 (MDA)含量变化。结果 :治疗组治疗后病情及CT分级明显优于非治疗组 ,脑脊液压力降低明显超过非治疗组 ,降低率分别为 3 8 8%和 11 98% (P <0 0 1) ;治疗组血浆SOD总活力升高明显高于非治疗组 ,升高率分别为 65 0 4%和 2 0 16% (P <0 0 1) ;而治疗组MDA含量则显著下降 ,下降率分别为 48 90 %和 2 8 2 1% (P <0 0 1)。脑脊液压力变化与血浆SOD总活力呈负相关 ,r =-0 84,与MDA含量呈正相关r=0 62 (P <0 0 1)。结论 :七叶皂苷纳通过清除自由基、清除脑水肿、降低颅内压、保护脑细胞而发挥治疗作用。
Objective: To investigate the mechanism of sodium aescinate in treating subarachnoid hemorrhage (SAH). Methods: Forty-seven patients with SAH were randomly divided into sodium aescinate treatment group (treated group) and non-sodium aescinate sodium treatment group (untreated group). The changes of disease, CT grade, cerebrospinal fluid pressure, Changes of total oxidative dismutase (SOD) and malondialdehyde (MDA) contents. Results: The condition and CT grade of the treated group were significantly better than those of the non-treated group, and the decrease of cerebrospinal fluid pressure was significantly lower than that of the non-treated group (38.8% and 11 98%, respectively; P <0.01) The increase of total vitality was significantly higher than that of non-treatment group (65 0 4% and 20 16% respectively) (P 0 01), while the MDA content of treatment group decreased significantly (48 90% and 2 8 2 1% (P <0 0 1). The changes of cerebrospinal fluid pressure were negatively correlated with the total plasma SOD activity, r = -084, and positive correlation with MDA content (r = 0 62) (P <0.01). Conclusion: Aescin can play a therapeutic role by scavenging free radicals, clearing cerebral edema, reducing intracranial pressure and protecting brain cells.