颅内微创穿刺血肿引流术治疗老年高血压脑出血效果及对NT―proBNPHMGB―1和GM―CSF水平影响.docVIP

颅内微创穿刺血肿引流术治疗老年高血压脑出血效果及对NT―proBNPHMGB―1和GM―CSF水平影响 　　[摘要] 目的 探讨颅内微创穿刺血肿引流术治疗老年高血压脑出血的效果及其对N末端脑钠肽前体（NT-proBNP）、高迁移率族蛋白1（HMGB-1）和血浆粒细胞巨噬细胞集落刺激因子（GM-CSF）水平的影响。 方法 选取2009年2月～2015年6月重庆市第五人民医院神经外科诊治的82例急性老年高血压脑出血患者为研究对象，根据手术方式的不同将患者分为颅内微创穿刺血肿引流术组（微创组）和小骨窗血肿清除术/去骨瓣减压血肿清除术（常规组），每组各41例，分别比较两组患者的临床疗效及其NT-proBNP、HMGB-1和GM-CSF的变化水平。 结果 术后7 d和14 d，两组出血量均较术前显著下降（P 0.05）。术后14 d常规组格拉斯哥昏迷评分（GCS）和Barthel指数均较术前明显升高，而美国国立卫生研究院卒中量表（NIHSS）评分显著降低（P 0.05）。术后7 d和14 d，微创组NT-proBNP、HMGB-1和GM-CSF水平均较术前显著下降（P 0.05）；常规组仅在术后14 d上述指标水平才出现明显降低（P 0.05）；而且，微创组患者NT-proBNP、HMGB-1和GM-CSF水平均显著低于常规组（P 0.05）。 结论 颅内微创穿刺血肿引流术可以有效清除老年高血压脑出血患者的出血病灶，调节脑内NT-proBNP、HMGB-1和GM-CSF水平，促进神经功能的恢复和生活质量的提高。 　　[关键词] 颅内微创穿刺血肿引流术；高血压脑出血；N末端脑钠肽前体；高迁移率族蛋白1；粒细胞巨噬细胞集落刺激因子 　　[中图分类号] R743.2 [文献标识码] A [文章编号] 1673-7210（2016）01（b）-0041-05 　　[Abstract] Objective To investigate the clinical effect of minimally invasive hematoma drainage in the treatment of elderly patients with hypertension cerebral hemorrhage and its effect on the levels of N-terminal pro-B-type natriuretic peptide （NT-proBNP）， high mobility group box-1 protein （HMGB-1） and granulocyte-macrophage colony-stimulating factor （GM-CSF）. Methods Eighty two cases of elderly patients with acute hypertensive cerebral hemorrhage treated in Department of Neurosurgery of the Fifth Peoples Hospital of Chongqing from February 2009 to June 2015 were selected as research objects， and they were divided into minimally invasive intracranial hematoma puncture drainage surgery group （minimally invasive group） and small bone window hematoma/craniotomy hematoma surgery group （conventional group） according to different surgical procedures， each group had 41 cases. The clinical efficacy and the levels of NT-proBNP， HMGB-1 and GM-CSF were compared respectively between two groups. Results After operation for 7 days and 14 days， the bleeding volume of the two groups were significantly decreased compared with before operation （P 0.05）. After operation for 14 days， the Glasgow coma sc