尤瑞克林联合依达拉奉对急性脑梗死患者作用机制的研究

Mechanism of edaravone combined with Urinary Kallidinogenase for acute cerebral infarction

目的:通过对急性脑梗死患者联合应用尤瑞克林和依达拉奉进行治疗,研究其对患者血清氧化低密度脂蛋白(ox-LDL)、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和T细胞亚群的影响,探讨联合用药对急性脑梗死患者的作用机制。方法:选取86例在我院进行诊治的急性脑梗死患者,随机分为对照组和观察组,每组43例患者。所有患者均根据自身具体情况给予一般治疗方案,包括降糖、调压、防治并发症、对症支持治疗等。对照组在此基础上给予30mg依达拉奉注射液静脉滴注,每天1次,连用14天;观察组在对照组治疗的基础上加用0.15PNA单位尤瑞克林静脉滴注,每天1次,连用14天。于治疗前后检测并比较两组血清ox-LDL、PCT、hs-CRP、TNF-α以及CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平的变化。结果:(1)治疗前,两组血清ox-LDL、PCT、hs-CRP、TNF-α水平之间比较,差异均无显著性(P>0.05);治疗后,两组血清ox-LDL、PCT、hs-CRP、TNF-α水平均明显降低,与同组治疗前相比,差异均具有显著性(P<0.05),且观察组血清ox-LDL、PCT、hsCRP、TNF-α水平改善程度明显优于对照组,差异均具有显著性(P<0.05)。(2)治疗前,两组血清CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平之间比较,差异均无显著性(P>0.05);治疗后,两组血清CD3^+、CD4^+、CD4^+/CD8^+水平明显升高,CD8^+水平明显降低,与同组治疗前相比,差异均具有显著性(P<0.05),且观察组血清CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平改善程度明显优于对照组,差异均具有显著性(P<0.05)。结论:对急性脑梗死患者联合应用尤瑞克林和依达拉奉进行治疗,可以明显改善患者血清ox-LDL、PCT、hs-CRP、TNF-a和T细胞亚群水平,进一步说明了其联合用药的协同增效作用,也说明两药用于急性脑梗死可以抑制血栓扩大,降低机体炎症反应,减轻脑组织损伤,改善神经功能。

Objective：To observe the effects of edaravone combined with Urinary Kallidinogenase on serum ox-LDL, PCT,hs-CRP,TNF-a and T cell subsets in patients with acute cerebral infarction,so as to explore the mechanisms of combina-tion therapy on patients with acute cerebral infarction.Methods：A total of 86 patients with acute cerebral infarction treated in our hospital from March 2014 to May 201 6 were randomly divided into ontrol group and observation group with 43 cases in each group.All patients were given general treatment according to their own specific conditions,including hypoglycemic,pres-sure adjustment,prevention and treatment of complications,symptomatic support therapy,etc..The control group were given 30 mg Edaravone injection on this basis once per day for 14 days.The observation group was treated with 0.1 5PNA Urinary Kallidinogenase intravenous drip once per day for 14 days based on the treatment of the control group.The levels of serum x-LDL、PCT、hs-CRP、TNF-αand CD3 ＋ 、CD4 ＋ 、CD8 ＋ 、CD4 ＋/CD8 ＋ were detected and compared between the two groups.Re-sults（1）Before treatment,there was no significant difference between the two groups in the levels of serum ox-LDL、PCT、hs-CRP、TNF-α;after treatment,the serum levels of ox-LDL,PCT,hs-CRP and TNF-αbetween the two groups （P 〈0.05）;（2） Before treatment,there was no significant difference between the two groups in levels of serum CD3 ＋ 、CD4 ＋ 、CD8 ＋ 、CD4 ＋/CD8 ＋ after treatment,the serum levels of CD3 ＋ ,CD4 ＋ and CD4 ＋/CD8 ＋ were significantly increased in the two groups,while the level of CD8 ＋ was significantly decreased compared with the same group before treatment,and the difference was signifi-cant（P 〈0.05）;and the levels of serum CD3 ＋ ,CD4 ＋ ,CD8 ＋ and CD4 ＋/CD8 ＋ in the observation group were significantly higher than those in the control group,and the difference was significant （P 〈0.05）.Conclusion：The treatment of combined application of Urinary Kallidinogenase and edaravone in patients with acute cerebral infarction can significantly improve the ser-um levels of ox-LDL,PCT,hs-CRP,TNF-a and T cell subsets,further illustrates the synergistic effect of the combination, which shows that the two drugs for acute cerebral infarction can inhibit thrombosis to expand,reduce inflammation,relieve cerebral tissue damage,improve neurological function.