注射用烟酸对介入治疗老年中度缺血性脑血管狭窄患者血液黏度、脑血流和血管痉挛的影响

The effect of niacin injection on blood viscosity,cerebral blood flow and vasospasm in elderly patients with moderate ischemic cerebrovascular stenosis treated with interventional therapy

中文关键词: 老年  中度缺血性脑血管狭窄  注射用烟酸  血液黏度  脑血流  脑血管痉挛

英文关键词: elderly  moderate ischemic cerebrovascular stenosis  niacin injection  blood viscosity  cerebral blood flow  cerebral vasospasm

中文摘要:

      目的 探究注射用烟酸对介入治疗老年中度缺血性脑血管狭窄患者血液黏度、脑血流和血管痉挛的影响.方法 选取2020 年1 月—2022 年10 月于开封一五五医院神经内科接受治疗的老年缺血性脑血管狭窄患者 78 例,按随机数字表法分为烟酸组和对照组,每组39 例.对照组于支架植入术后进行口服抗血小板、调节血脂药物,注射神经保护剂等常规治疗,烟酸组在对照组治疗基础上加用静脉滴注注射用烟酸.2 组疗程均为7d.观察并比较2 组患者治疗前后神经功能评分、日常活动Barthel指数(BI)、血液黏度、脑血流灌注、血管痉挛和其他不良反应发生情况.结果 治疗后,烟酸组改良美国国立卫生研究院卒中量表(NIHSS)评分低于对照组(P＜0.05),BI高于对照组(P＜0.05);烟酸组全血高切黏度、全血低切黏度和血浆黏度均低于对照组(P＜0.05);烟酸组脑血容量(CBV)、脑血流量(CBF)值均高于对照组(P＜0.05),烟酸组对比剂平均通过时间(MTT)值低于对照组(P＜0.05);烟酸组脑血管痉挛发生率低于对照组(P＜0.05),而2 组皮肤潮红、皮疹、血管损害等其他不良反应发生率差异无统计学意义(P＞0.05).结论 注射用烟酸可降低介入治疗老年中度缺血性脑血管狭窄患者的血液黏度,改善脑血流和脑血管痉挛情况,且具有较好的安全性.

英文摘要:

      Objective To explore the effect of niacin injection on blood viscosity, cerebral blood flow and vasospasm in elderly patients with moderate ischemic cerebrovascular stenosis treated with interventional therapy. Methods 78 elderly pa? tients with ischemic cerebrovascular stenosis who received treatment in Department of Neurology of Kaifeng Hospital 155 from January 2020 to October 2022 were selected and divided into niacin group and control group according to random number table method, with 39 cases in each group. The control group received routine treatments after stent implantation, such as oral anti? platelet drugs, lipid?regulating drugs and injection of neuroprotective agents. The niacin group received intravenous infusion of niacin injection on the basis of treatment in the control group. The treatment course of both groups was 7 days. The neurologi? cal function score, daily activity Barthel index (BI), blood viscosity, cerebral blood perfusion, vasospasm and other adverse reactions before and after treatment were observed and compared between the two groups. Results After treatment, the score of Modified National Institutes of Health Stroke Scale (NIHSS) of the niacin group was lower than that of the control group (P < 0. 05), and BI was higher than that of the control group (P <0. 05); the whole blood high?shear viscosity, whole blood low? shear viscosity and plasma viscosity of the niacin group were lower than those of the control group (P <0. 05); the cerebral blood volume (CBV) and cerebral blood flow (CBF) of the niacin group were higher than those of the control group (P <0. 05); the mean transit time (MTT) of contrast agent in the niacin group was shorter than that in the control group (P <0. 05). The inci? dence of cerebral vasospasm in the niacin group was lower than that in the control group (P <0. 05), but there was no significant difference in the incidence of other adverse reactions such as skin flushing, rash and vascular damage between the two groups (P >0. 05). Conclusion Niacin injection can reduce blood viscosity and improve cerebral blood flow and cerebral vasospasm in elderly patients with moderate ischemic cerebrovascular stenosis treated with interventional therapy, and it has good safety.