目的 探討桂哌齊特聯(lián)合法舒地爾治療腦動(dòng)脈瘤栓塞術(shù)后的腦血管痙攣的臨床療效。方法 選取2012年6月—2017年6月在大連大學(xué)附屬中山醫(yī)院治療的腦動(dòng)脈瘤栓塞術(shù)后腦血管痙攣的患者152例，隨機(jī)分為對(duì)照組（76例）和治療組（76例）。對(duì)照組靜脈滴注鹽酸法舒地爾注射液，30 mg加入100 mL生理鹽水，3次/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注馬來(lái)酸桂哌齊特注射液，320 mg加入10%葡萄糖溶液500 mL，2次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者NFI評(píng)分、Glasgow昏迷評(píng)分、Barthel指數(shù)評(píng)分、經(jīng)顱多普勒（TCD）指標(biāo)和血清學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組的臨床總有效率為80.26%，顯著低于治療組的94.74%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組NFI評(píng)分明顯降低，Glasgow昏迷和Barthel指數(shù)評(píng)分明顯升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組NFI評(píng)分、Glasgow昏迷和Barthel指數(shù)評(píng)分比對(duì)照組改善更顯著（P < 0.05）。治療后，兩組雙側(cè)大腦前動(dòng)脈（ACA）、大腦中動(dòng)脈（MCA）和大腦后動(dòng)脈（PCA）血流速度均顯著增加（P < 0.05）；且治療組比對(duì)照組增加更顯著（P < 0.05）。治療后，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）和內(nèi)皮素-1（ET-1）水平顯著降低，一氧化氮（NO）和6-酮-前列腺素F1α（6-K-PGF1α）水平顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組血清學(xué)指標(biāo)改善后水平明顯優(yōu)于對(duì)照組（P < 0.05）。結(jié)論 馬來(lái)酸桂哌齊特聯(lián)合法舒地爾治療腦動(dòng)脈瘤栓塞術(shù)后的腦血管痙攣可有效改善患者意識(shí)狀態(tài)，抑制機(jī)體炎癥細(xì)胞因子表達(dá)，增加腦血流速度，促進(jìn)神經(jīng)功能損傷修復(fù)。

Objective To investigate the clinical curative effect of cinepazide combined with fasudil in treatment of cerebral vasospasm after cerebral aneurysm embolization. Methods Patients (152 cases) with cerebral vasospasm after cerebral aneurysm embolization in Affiliated Zhongshan Hospital of Dalian University from June 2012 to June 2017 were randomly divided into control (76 cases) and treatment (76 cases) groups. Patients in the control group were iv administered with Fasudil Hydrochloride Injection, 30 mg added into normal saline 100 mL, three times daily. Patients in the treatment group were iv administered with Cinepazide Maleate Injection on the basis of the control group, 320 mg added into 5% glucose solution 500 mL, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NFI, Glasgow and Barthel scores, TCD indexes, and serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.26%, which was significantly lower than 94.74% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the NFI scores in two groups were significantly decreased, but Glasgow and Barthel index scores were significantly increased, and the difference was statistically significant in the same group (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the blood flow rate of ACA, MCA, and PCA in two groups was significantly increased (P < 0.05), and the blood flow rate in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the hs-CRP, IL-6, TNF-α and ET-1 levels in two groups were significantly decreased, but NO and 6-K-PGF1α levels were significantly increased, there were differences in the same group (P < 0.05), and the serological indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Cinepazide combined with fasudil in treatment of cerebral vasospasm after cerebral aneurysm embolization can effectively improve the consciousness, inhibit inflammatory cytokine expression and reduce cerebral blood flow, also promote the repair of nerve injury.