亚低温联合依达拉奉治疗急性脑梗死的疗效及对血清hs-CRP、NSE、S100-β蛋白水平的影响

The Influence of Mild Hypothermia Combined with Edaravone on Serum hs-CRP,NSE and S100-β in the Treatment of Acute Cerebral Infarction

目的 研究亚低温联合依达拉奉治疗急性脑梗死的疗效及对血清超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、神经元特异性烯醇化酶(Neuron-specific enolase ,NSE)、S100钙结合蛋白β(S100 calcium binding protein β,S100-β)水平的影响。方法 选取郑州大学附属郑州中心医院收治的急性脑梗死病人96例,随机分为对照组和研究组,各48例。对照组单纯予以依达拉奉治疗,研究组在此基础上施加亚低温治疗。比较两组治疗总有效率、不良反应情况等。记录治疗前后两组神经功能缺损(National Lnstitute of Health Stroke Scale, NHISS)评分和日常生活活动能力(Ability of Daily Life, ADL)评分。采集病人治疗前后血液样本,检测血清hs-CRP、NSE、S100-β蛋白水平及血浆超氧化物歧化酶(su-peroxidedismutase, SOD)和丙二醛(malondialdehyde,MDA)水平。结果 研究组治疗总有效率(91.67%)明显高于对照组(75.00%,χ2=4.80, P =0.03);治疗后,研究组血清学指标hs-CRP、S100-β、NSE均明显低于对照组(均 P <0.01);研究组SOD水平高于对照组( P <0.01),而MDA低于对照组( P <0.01);研究组ADL评分高于对照组( P <0.01),而NHISS评分低于对照组( P <0.01);两组不良反应发生率比较差异无统计学意义( P >0.05)。结论 亚低温联合依达拉奉治疗急性脑梗死疗效显著,可有效改善相关血清学指标,减轻体内氧化应激反应,改善病人神经功能及预后,且较安全可靠。

Objective To observe the influence of mild hypothermia combined with edaravone on the expression of high-sensitivity C-reactive protein (hs-CRP),neuron-specific enolase (NSE), and S100 calcium binding protein β(S100-β) in the treatment of acute cerebral infarction.Methods Ninty-six patients with acute cerebral infarction were randomly divided into the control group and the study group,48 cases in each group.The control group was treated with edaravone,and the study group was treated with mild hypothermia on the basis of the control group.The total effective rate,adverse reactions ,the National Institute of Health Stroke Scale (NHISS) score ,the Ability of Daily Life (ADL) score,the levels of hs-CRP,NSE,S100-β and superoxide dismutase (SOD),and malondialdehyde (MDA) levels were compared between two groups.Results The total effective rate in the study group was significantly higher than that in the control group (91.67% vs 75.00%, P =0.03).After treatment,the levels of hs-CRP,S100-β,and NSE in the study group were significantly lower than those in the control group ( P <0.01).The level of SOD in the study group was significantly higher than that in the control group ( P < 0.01),while MDA was significantly lower than that in the control group ( P <0.01).The ADL scores in the study group were significantly higher than those in the control group ( P <0.01),while the NHISS score was significantly lower than that in the control group ( P <0.01).Conclusion Mild hypothermia combined with edaravone had significant therapeutic effect on acute cerebral infarction,which could effectively optimize the relevant serological markers,reduce the oxidative stress,improve the neurological function and prognosis.