倍他司汀联合丹参酮ⅡA磺酸钠治疗前庭性眩晕患者的效果及对血清ET-1/25-OHD水平的影响-现代医学

倍他司汀联合丹参酮ⅡA磺酸钠治疗前庭性眩晕患者的效果及对血清ET-1/25-OHD水平的影响

单位：上海市宝山区中西医结合医院耳鼻喉科, 上海 201900

分类号：R764

出版年·卷·期（页码）：2020·48·第二期（244-248）

摘要：

目的： 探讨倍他司汀联合丹参酮ⅡA磺酸钠治疗前庭性眩晕的效果及其对患者血清内皮素（ET）-1、25羟维生素D（25-OHD）水平的影响。方法： 2015年4月~2017年4月在我院治疗的前庭性眩晕症患者96例作为研究对象，随机数字表法随机分为对照组（n=48）和观察组（n=48）。对照组给予常规治疗以及甲磺酸倍他司汀片口服，观察组在此基础上加用丹参酮ⅡA磺酸钠静滴，观察两组患者治疗疗效，前庭症状指数（VSI）、眩晕残障程度评定量表（DHI）评分以及Berg平衡量表（BBS）评分，脑部血流指标以及血清内皮素-1和血清25羟维生素D水平。结果： 观察组总有效率为87.5%，显著高于对照组患者的70.83%，差异具有统计学意义（P<0.05）；观察组患者的VSI、BBS、DHI评分以及左右椎动脉（LVA、RVA）和基底动脉（BA）血流改善情况均显著优于对照组患者，差异均有统计学意义（P<0.05）；治疗后两组患者血清ET-1水平降低，血清25-OHD较治疗前升高，而观察组血清ET-1和25-OHD水平变化幅度大于对照组，差异具有统计学意义（P<0.05）。结论： 倍他司汀联合丹参酮ⅡA磺酸钠治疗前庭性眩晕的疗效确切，具有较高的有效率，可明显改善患者的症状，改善VSI、BBS以及DHI评分，改善脑部血流，其作用机理可能与降低ET-1的分泌和释放及增加25-OHD水平、改善机体钙代谢有关。

Objective: To investigate the effect of betahistine combined with sodium tanshinone ⅡA sulfonate on vestibular vertigo and its influence on serum levels of endothelin-1 and 25-hydroxyvitamin D (25-OHD). Methods: From April 2015 to April 2017, 96 patients with vestibular vertigo were randomly divided into control group (n=48) and observation group (n=48). The control group was given routine treatment and betastatine mesylate tablets orally. The observation group was given sodium tanshinone ⅡA sulfonate intravenously on top of the routine treatment. The therapeutic effect, vestibular symptom index (VSI), vertigo disability assessment scale (DHI), Berg balance scale (BBS), cerebral blood flow index and brain blood flow index were observed as well as serum endothelin-1 and serum 25 hydroxyvitamin D levels. Results: The total effective rate of the observation group was 87.5%,higher than that of the control group (70.83%, P<0.05). The VSI, BBS, DHI scores, left and right vertebral artery (LVA, RVA) and basilar artery (BA) blood flow improvement of the observation group were significantly better than those of the control group (P<0.05). After treatment, the levels of ET-1 and 25-OHD in serum of the two groups were lower than those of the control group, and the changes of ET-1 and 25-OHD in the observation group were more significant than those of the control group (P<0.05). Conclusion: Betastatin combined with sodium tanshinone ⅡA sulfonate is effective in the treatment of vestibular vertigo. It can obviously improve the symptoms, VSI, BBS and DHI scores, and improve cerebral blood flow. The mechanism may be related to the reduction of ET-1 secretion and release, the increase of 25-OHD level, and the improvement of calcium metabolism.

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