高博,吕涛,唐琴,白洁
GAO Bo,LV Tao,TANG Qin,BAI Jie

• 1:延安大学附属医院神经内科
• 2:榆林市第一医院神经内科
• 3:新疆维吾尔自治区人民医院放射影像中心
• 4:华北理工大学附属医院神经内科

摘要(Abstract)：

目的探讨马来酸桂哌齐特联合甲磺酸倍他司汀对后循环缺血性眩晕患者的治疗效果。方法选取后循环缺血性眩晕患者80例,随机均分为对照组(甲磺酸倍他司汀治疗)和观察组(马来酸桂哌齐特联合甲磺酸倍他司汀治疗),收集2组患者的一般临床资料,采用视频眼震图仪检测2组患者治疗前、治疗后2周的自发性眼震、扫视试验、平滑跟踪试验及位置试验,采用彩色多普勒超声诊断仪(TCD)检测左椎动脉(LVA)、右椎动脉(RVA)、基底动脉(BA)的平均血流速度;分别采集2组患者治疗前、治疗后2周空腹静脉血5 mL,采用酶联免疫吸附法检测血清血小板衍生生长因子-BB(PDGF-BB)和一氧化氮合成酶(NOS)水平;采用眩晕障碍量表(DHI)分别于治疗前、治疗后2周对2组患者进行临床疗效评价。结果 2组患者治疗后眼震电图显示眼震峰速下降、潜伏期延长、精确度下降、欠冲及过冲发生率均较治疗前下降(P<0.05),且治疗后观察组发生率低于对照组(P<0.05);观察组后循环缺血性眩晕患者平滑跟踪试验Ⅲ、Ⅳ型异常检出率和位置试验Ⅰ、Ⅱ及Ⅲ型检出率分别低于对照组(P<0.05),血清PDGF-BB和NOS水平低于对照组,但TCD各动脉血管血流速度高于对照组(P<0.05);观察组后循环缺血性眩晕患者治疗总有效率(95.00%)高于对照组(72.50%),差异有统计意义(χ~2=5.41,P=0.02)。结论与单纯甲磺酸倍他司汀治疗方法相比,马来酸桂哌齐特联合甲磺酸倍他司汀可改善后循环缺血性眩晕患者的眼震异常状态、血清PDGF-BB和NOS水平、TCD指标,从而提高临床疗效。
Objective To investigate the therapeutic effect of cinepazide maleate combined with betahistine mesilate on patients with posterior circulation ischemic vertigo(PCIV).Methods Eighty patients with PCIV were randomly divided into control group(treated with betahistine mesilate) and observation group(treated with cinepazide maleate combined with betahistine mesilate). The general clinical data was collected from two groups. Videonystagmography( VNG) was applied to detect spontaneous nystagmus, saccade test, smooth tracking test and position test before treatment and 2 weeks after treatment. Color transcranial doppler(TCD) was used to measure the average blood flow velocities of left vertebral artery(LVA), right vertebral artery(RVA),and basilar artery(BA). Five mL of fasting venous blood were collected before treatment and 2 weeks after treatment. ELISA assay was used to detect serum platelet-derived growth factor-BB( PDGF-BB) and nitric oxide synthase(NOS). Dizziness handicap inventory(DHI) was used to assess vertigo status of two groups before and 2 weeks after treatment in order to evaluate therapeutic effect.Results After treatment, VNG images exhibited that peak velocity, prolongation of latency, accuracy and incidences of undershoot and overshoot were decreased in two groups(P< 0. 05), and they were lower in observation group than those in control group(P< 0. 05). The detection rates of type Ⅲ and Ⅳ abnormalities in the smooth tracking tests and the detection rates of type Ⅰ, Ⅱ, and Ⅲ in position tests were less in observation group than those in control group(P< 0. 05). Serum PDGF-BB and NOS levels were lower in observation group than those in control group, but the blood flow velocities of the arteries of TCD were higher in observation group than those in control group(P< 0. 05). Total therapeutic effective rate in observation group was 95. 00%, higher than 72. 50% in control group （χ~2= 5. 41,P= 0. 02）.Conclusion Compared with betahistine mesilate alone, cinepazide maleate combined with betahistine can improve the abnormal state of nystagmus, serum PDGF-BB, NOS, and TCD indexes, leading to improve clinical efficacy.

关键词(KeyWords)： 眼震电图描记术;一氧化氮合酶;后循环缺血性眩晕;马来酸桂哌齐特;甲磺酸倍他司汀;血小板衍生生长因子-BB
electronystagmography;nitric oxide synthase(NOS);posterior circulation ischemic vertigo;cinepazide maleate;betahistine mesilate;platelet-derived growth factor-BB(PDGF-BB)

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高博,吕涛,唐琴,白洁
GAO Bo,LV Tao,TANG Qin,BAI Jie

DOI: 10.19367/j.cnki.2096-8388.2022.01.020

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