Effect Simvastatin Combined with Nimodipine on Oxidative Stress and Inflammatory Factors in Patients withCVSafterSAH/GUO Xiao，WU Zengbao.//Medical Innovation China，2025，22（16）：063- 067

[Abstract]Objective：To investigate the efect Simvastatin combined with Nimodipine on patients with cerebral vascular spasm （CVS）after subarachnoid hemorrhage （SAH）.Method： A total 77 patients with CVS after SAHadmited to the Department Neurosurgery itional Chinese Medicine from September 2O21 to December 2O23 were included retrospectivelyand grouped in accordance with diffrent treatment modalities，the single group （n=38） was treated with Nimodipine，and the combined group （ n =39）was treated with Simvastatinonthe basis the single group.The clinical eficacy，inflammatory factors andoxidativestressindexes the two groups were compared. Result： After treatment， the total clinical effctive rate （94.87 % ） the combined group was higher than that （ 78.95% ） the single group，the difference was statistically significant （ P lt;0.05）. Before treatment，there wereno significantdifferences inthelevels inflammatoryfactorsandoxidativestress indexes between the two groups （ P₂ 0.05）;after treatment，the inflammatory factors in combined groupwerelower than those in single group，the level superoxide dismutase （SOD）was higher thanthat insingle group，and the level malondialdehyde （MDA）was lower than that in single group，the diffrences were statistically significant （ P lt;0.05）. Conclusion： Simvastatin combined with Nimodipine inthe treatment patients with CVS after SAHcan effectively promote the rehabilitation thepatients，reduce the inflammatory factors in the patients，and improve the level oxidative stress.

[Key Words]Simvastatin NimodipineSubarachnoid hemorrhage Cerebral vascular spasm

First-author'saddress：Department Neurosurgery，itional Chinese ledicine，435400，China

doi：10.3969/j.issn.1674-4985.2025.16.016

蛛网膜下腔出血（SAH）是一种严重的脑血管疾病，其主要特征是血液流入脑底部或脊髓周围的蛛网膜下腔，通常由于脑血管畸形、高血压动脉硬化、血液疾病、脑外伤和颅内肿瘤等颅内动脉瘤破裂引发{。脑血管痉挛（CVS）是SAH患者常见的严重并发症之一，其发生率在 30%～70% 。早期由于SAH后血液渗出到蛛网膜下腔，导致颅内压急剧增高和血管自动调节能力下降，加上血凝块对颅底管壁的刺激，进而导致CVS的发生，该疾病具有较高的致残率和致死率[2]。目前，治疗SAH后CVS疾病主要以药物为主，尼莫地平作为一种钙通道阻滞剂，通过阻断电压门控钙离子通道，减少血管平滑肌细胞内钙离子的内流，从而抑制平滑肌收缩，具有舒张血管、缓解脑血管痉挛等作用[3。虽然尼莫地平在预防和治疗蛛网膜下腔出血后脑血管痉挛方面具有显著效果，但SAH后CVS是一个复杂的病理过程，需要多种治疗方法的综合应用，单一给药的应用具有一定局限性[4。辛伐他汀作为一种调脂药物，在治疗高脂血症方面具有显著的效果和良好的安全性，通过调节炎症反应和血管舒张功能来减轻CVS症状[5]。张丽平等在研究中表示，在临床应用中，可根据患者的具体情况选择合适的剂量，与尼莫地平联合治疗以获得更好的临床效果。对此，本文回顾性纳入2021年9月—2023年12月武穴市中医医院神经外科收治的77例SAH后CVS患者，分析辛伐他汀联合尼莫地平的治疗效果，旨在为临床实践提供客观依据。

1资料与方法