依达拉奉对急性脑出血患者血清炎性因子及超氧化物歧化酶的影响

Influence of edaravone on inflammatory cytokines and oxidative stress products in patients with acute cerebral hemorrhage

目的探讨依达拉奉对急性脑出血患者血清炎性因子及超氧化物歧化酶（SOD）的影响。方法选取高密市人民医院2014年9月至2016年12月收治的急性脑出血患者120例为研究对象，采用随机数字表法分为研究组60例、对照组60例，两组患者均给予脱水、降颅内压、改善脑组织代谢等常规治疗，研究组在常规治疗基础上给予依达拉奉治疗，治疗2周后比较两组患者临床疗效、炎性因子、SOD、神经功能及生活能力改善情况。结果研究组总有效率高于对照组（90．0％比80．0％），但差异无统计学意义（χ^2=2．353，P〉0．05）。治疗前两组炎性因子水平差异均无统计学意义（t=0．061、0．152、0．698、0．309、0．146、0．148，均P〉0．05）；治疗后，研究组肿瘤坏死因子仅（TNF-α）、白细胞介素6（IL-6）、C反应蛋白（CRP）、内皮素（ET）、IL-8、IL-1β分别为（34．48±8．93）μg/L、（41．83±13．86）μg/L、（27．56±4．73）mg／L、（3．15±0．72）μg/L、（24．83±7．51）ng／L、（9．75±3．16）ng／L，均低于对照组的（45．08±9．76）μg/L、（56．87±14．62）μg/L、（36．37±5．81）mg／L、（4．76±1．12）μg/L、（38．89±8．34）ngL、（14．72±4．43）ng／L，差异均有统计学意义（t=6．207、5．783、9．109、9．366、9．704、7．075，均P〈0．05）。治疗前两组氧化应激产物水平差异均无统计学意义（t=0．141、0．525，均P〉0．05）；治疗后，研究组SOD、丙二醛（MDA）分别为（61．49±5，47）U／mL、（2．81±0．43）mo]／L，均低于对照组的（72．53±4．84）U／mL、（3．67±0．49）mol／L，差异均有统计学意义（t=11．708、10．218，均P〈0．05）。治疗后研究组日常生活活动能力量表（ADL）、美国国立卫生研究院卒中量表（NIHSS）评分分别为（63．85±5．74）分、（4．75±2．04）分，对照组分别为（55．63±6．78）分、（7．46±2．17）分，两组差异均有统计学意义（t=7．048、7．167，均P〈0．05）。结论依达拉奉可显著减轻急性脑出血患者氧化应激及炎性反应，有利于神经功能及生活能力的改善。

Objective To investigate the influence of edaravone on inflammatory cytokines and oxidative stress products in patients with acute cerebral hemorrhage. Methods From September 2014 to December 2016,120 patients with acute cerebral hemorrhage in the People＇s Hospital of Gaomi were chosen and divided into control group and research group according to the digital table, with 60 cases in each group. The two groups were treated with dehydration, reducing intraeranial pressure, improving the metabolism of brain tissue and other conventional treatment. The research group was treated with edaravone on the basis of routine treatment. After treatment for 2 weeks, the clinical effects, inflammatory eytokines, SOD, nerve function and life ability between the two groups were compared. Results The total effective rate of the research group was higher than that of the control group （90. 00% vs. 80. 00% ） , but the difference was not statistically significant （ χ^2 = 2. 353, P 〉 0.05 ）. Before treatment, the levels of inflammatory cytokines between the two groups had no statistically significant differences （t = O. 061,0. 152,0. 698, 0. 309,0. 146,0. 148, all P 〉 0.05 ）. After treatment ,the levels of tumor necrosis factor alpha（ TNF -α ） , interleukin 6 （ IL - 6 ）, C reactive protein（ CRP）, endothelin（ ET）, interleukin 8 （ IL - 8 ） and interleukin 1 beta（ IL - 1 beta） in the research group were （ 34.48± 8.93 ）μg/L, （ 41.83 ± 13.86 ） μg/L, （27.56 ± 4.73 ） mg/L, （ 3.15 ± 0.72） μg/L, （24.83±7.51 ） ng/L, （9.75 ±3.16） ng/L,respeetively,which were lower than those in the control group[ （45.08 ± 9.76 ） μg/L, （56.87 ± 14.62）μg/L, （36.37 ± 5.81 ） mg/L, （4.76 ± 1.12 ） μg/L, （38.89 ± 8.34 ） ng/L, （ 14.72 ± 4.43 ） ng/L ] , the differences were statistically significant （ t = 6. 207,5. 783,9. 109,9. 366,9. 704,7. 075, all P 〈0. 05 ）. Before treament, the levels of oxidative stress products between the two groups had no statistically significant differences （ t = 0. 141,0.525, all P 〉 0.05 ）. After treatment, the levels of superoxide dismutase （ SOD ） and malondi- aldehyde （MDA） of the research group were （ 61.49±5.47 ） U/mL, （ 2.81 ±0.43 ） mol/L, respectively, which were lower than those in the control group [ （72.53±4.84） U/mL, （ 3.67 ± 0.49 ） mol/L ], the differences were statistically significant （t = 11. 708,10.218, all P 〈 0.05 ）. After treatment, the daily activity scale （ADL）, the National Institutes of Health Stroke Scale（NIHSS） of the research group were （63.85 ± 5.74 ） , （4.75 ± 2.04 ）, which of the control group were （55.63±6.78）, （7.46 ± 2. 17 ）, respectively, the differences were statistically significant （t = 7. 048, 7. 167, all P 〈 0.05 ）. Conclusion Edarvone has good control effects on inflammation and oxidative stress reaction,it is conducive to the improvement of neurological function and life ability.