依达拉奉对急性脑梗死患者血管内皮功能的影响

Effects of edaravone on endothelial cell function in patients with acute cerebral infarction

目的 观察依达拉奉对急性脑梗死患者血管内皮细胞功能的保护作用.方法 选择急性脑梗死患者260例,随机分为治疗组和照组,各130例,对照组口服阿司匹林100 mg,1次/d,辛伐他汀20mg,睡前服;治疗组在对照组治疗的基础上加用依达拉奉30 mg静脉滴注,2次/d,共14 d.分别于治疗前和治疗后第1、3、7、14、21天测定血浆NO、血浆内皮素1、血浆可溶性血栓调节蛋白（sTM）和血管性血友病因子（vWF）,并观察中国卒中量表（CSS）、日常生活能力量表（ADL）评分及循环内皮细胞数.结果 对照组治疗后第3、7、14、21天血浆NO浓度分别为（8.19±3.29）、（9.26±4.32）、（10.17±5.28）、（9.86±4.76）μg/L,sTM浓度分别为（5.67±0.63）、（7.64±0.71）、（9.85±1.26）、（7.89±1.12）μg/L,vWF浓度分别为（52.47±7.13）%、（76.59±8.17）%、（86.52±9.16）%、（68.94±7.52）%,ADL评分分别为（39.99±9.14）、（43.64±9.73）、（48.36±9.85）、（46.78±8.94）分.治疗组治疗后第3、7、14、21天血浆NO浓度分别为（9.85±4.57）、（12.57±5.39）、（15.42±6.73）、（13.28±5.68）μg/L,sTM浓度分别为（9.79±0.82）、（12.93±1.04）、（21.26±3.12）、（15.86±2.85）μg/L,vWF浓度分别为（78.95±6.73）%、（125.61±11.89）%、（216.75±32.85）%、（178.73±25.83）%,ADL评分分别为（53.68±9.s3）、（58.79±11.25）、（69.72±13.61）、（68.63±11.29）分.在治疗后第3、7、14、21天,治疗组血浆NO、sTM、vWF浓度及ADL评分均明显高于对照组（P〈0.05）,而血浆内皮素1浓度、CSS评分及循环内皮细胞数均明显低于对照组（P〈0.05）.结论 依达拉奉能有效保护急性脑梗死患者血管内皮细胞功能,减轻内皮细胞的损伤与脱落入血.

Objective To investigate the effeets of edaravone on endothelial cell function in patients with acute cerebral infarction.Methods Two hundred and sixty patients with acute cerebral infarction were randomly divided into treatment group（n=130）and control group（n=130）.Treatment group received edaravone injection （30 mg,bid）based on the routine therapy.The Nitric oxide（NO）,endothelin-1,plasma soluble thrombomodulin （sTM）,yon willebrand factor（vWF）,China stroke scale（CSS）score,daily living skills rating scale（ADL）Score and the number of cireulation endothehal cell at the time of 1,3,7,14,21 d after treatment were determined.CSS,ADL SCOre and circulatory endothelial cell number were observed.Results Plasma NO concentration of the control respectively;sTM concentration was（5.67±0.63）,（7.64±0.71）,（9.85±1.26）,（7.89±1.12）μg//L,respec-tively;vWF concentration was（52.47±7.13）,（76.59 4-8.17）,（86.52±9.16）,（68.94±7.52）%respectively;ADL score was（39.99±9.14）,（43.64±9.73）,（48.36±9.85）,（46.78±8.94）points.while the data of the treatment group were（9.85±4.57）,（12.57 ±5.39）,（15.42±6.73）,（13.28±5.68）μg/L;（9.79±0.82）,（12.93±1.04）,（21.26±3.12）,（15.86±2.85）μg/L;（78.95±6.73）,（125.61±11.89）,（216.75 4-32.85）.（178.73±25.83）%;（53.68±9.83）,（58.79±11.25）,（69.72±13.61）,（68.63±11.29）points,re-spectively.Compared with the control group,the serum concentration of NO,sTM,vWF and ADL score of the treat-ment group were significantly inereased.However,the serum concentration of ET-1,CSS score and the number of circulation endothelial cell were markedly decreased.Conclusion Edaravone protects the endothelial cell effectively by decreasing the endothelial cell injury.