| Intracerebral hemorrhage (ICH) is the common disease in theneurology and its mortality and rate of incapacity all are the top ofcerebrovascular disease. It is the threatener for life of people. Aroundhematoma, there is a series of physical and pathological changes,including edema, decreasing of local cerebral blood flow and neuronicinjury .Regional cerebral flow (rCBF) is a important standard aboutischemia. Xenon enhance CT (Xe-CT) measures rCBF by the use ofCT technique and the stabilization of Xe gas. It is the main method ofcount rCBF. Now, ischemia around hematoma in ICH is consideredone of causes of cerebral edema. It is considered that there is positivecorrelation between the content of Matrix metalloproteinase-9(MMP-9) and the volume of cerebral edema after ICH, so it can reflectthe degree of cerebral edema. Now, the treatment with ICH includedecreasing the intracranial pressure,allopathy and surgical therapy. Inrecent years some experts have tried to improve cerebral flow to treatthe patients with ICH by the use of traditional Chinese medicine. [Object]: To research the change of rCBF around hematoma inpatients with ICH by Xe-CT perfusion technique, analyse the periodand degree of ischemia around hematoma;determine the level ofMMP-9 in plasma, and discuss the effect of Panax notoginsengsaponins(PNS) for rCBF around hematoma,deepness of MMP-9 inplasma and neurological function. To verify the feasibility andeffectiveness of ameliorating circulation by use of PNS after ICH.[Method]: 14 patients with acute intracerebral hemorrhage(hematoma volume≤30ml) were randomly assigned to 2 treatmentgroups. Control group included 8 cases and were treated with basictherapy like dehydration,allopathysupport and so on. PNS groupincluded 6 cases and were treated with PNS after onset 24 hours. Thetreatments lasted 2 weeks. All cases performed Xe-CT within 24 hoursand at the 15th day after symptom onset and quantitively analysed therCBF in perihemorrhagic region and their contralateral region. At thesame time, all patients were measured respectively the contents ofMMP-9 in plasma by ELASA method within 24 hours and at the 4thday,15th days after symptom onset. The Chinese Stoke Scale (CSS)were recorded at the beginning of treatment and at the 15th day, 28thday after treatment.[Results]: The rCBF around hematoma of all cases lightlydescended on 24h after symptom onset and obviously decreased at the15th day. The absolute value of rCBF was in the range of ischemicpenumbra at the 15th day. Compared with the control group, the rCBFin perihemorrhagic region in PNS group had significant difference atthe 15th day (P<0.05). The contents of MMP-9 in plasma increased atthe 4th day and obviously decreased at the 15th day;there wassignificant difference of the contents of MMP-9 between PNS groupand control group at the 4th day and 15th day (P<0.05). Functionaldeficits in observing points were no difference between two groups atthe 15th day and PNS group showed difference at the 28th daycompared with initial score and control group.[Conclusion]:1. Xe-CT is a fast,safe and convenient method for measuringCBF. It can provide high precise,quantitative rCBF which can bemeasured repeatedly. It has high sensitivity to rCBF in the deep part ofbrain tissue.2. For patients with acute intracerebral hemorrhage,perihemorrhagic rCBF reduces slightly at early phase, however, itdecreases further enough to become ischemic penumbra at the 15thdays after symptom onset.3. For patients with acute intracerebral hemorrhage, the contentsof MMP-9 in plasma has a change and increase at the 4th day andobviously decrease at the 15th day.4. For patients with acute intracerebral hemorrhage, PNS canincrease the rCBF around hematoma.5. For patients with acute intracerebral hemorrhage, PNS canreduce the contents of MMP-9 in plasma. It indicates PNS can lightenthe secondary cerebral edema after ICH.6. For patients with acute intracerebral hemorrhage, PNS canimprove recovery of neurological function. It is concerned with theincreasing of rCBF.
|
PDF Full Text Request