依达拉奉辅助治疗颅内动脉瘤术后患者的临床效果及对其神经功能和自由基相关指标水平的影响

Effect of edaravone adjuvant therapy on neurologic function and free radicals in patients after intracranial aneurysm surgery

目的探讨依达拉奉辅助治疗颅内动脉瘤术后患者的临床效果及对其神经功能和自由基相关指标水平的影响。方法选取2015年3月至2017年6月于新疆医科大学附属中医医院接受显微夹闭术治疗的62例颅内动脉瘤患者为研究对象,按照随机数字表法分为观察组和对照组,各31例。对照组患者术后行常规用药治疗,观察组在对照组基础上另辅用依达拉奉治疗,2组均共治疗4周。采用格拉斯哥预后评分量表(GOS)评价患者的治疗效果;统计患者治疗期间的并发症发生情况;治疗第1、14、30天,采用美国国立卫生研究院卒中量表(NIHSS)对患者神经功能进行评估,采用经颅多普勒超声测定大脑中动脉血流速度(VMCA);治疗第1、30天,抽取患者的空腹晨血检测血清超氧化物歧化酶(SOD)、一氧化氮和丙二醛水平。结果术后3个月观察组GOS评分为5分患者的比例为74.2%(23/31),明显高于对照组的58.1%(18/31),差异有统计学意义(P <0.001)。观察组的并发症总发生率明显低于对照组[6.5%(2/31)比22.6%(7/31)],差异有统计学意义(P<0.001);观察组、对照组治疗第14、30天的NIHSS评分和VMCA均呈逐渐下降趋势,且观察组明显低于对照组[(5.1±1.4)分比(7.2±1.5)分、(3.3±1.3)分比(5.7±1.4)分、(83±5)cm/s比(96±5)cm/s、(74±4)cm/S比(84±4)cm/s],差异均有统计学意义(均P<0.05)。观察组治疗第30天的SOD水平明显高于本组治疗第1天和相应对照组,一氧化氮、丙二醛水平明显低于本组治疗第1天和相应对照组,差异均有统计学意义(均P <0. 05)。结论颅内动脉瘤术后辅用依达拉奉治疗的临床疗效显著,可明显改善患者神经功能,对患者血清SOD、一氧化氮和丙二醛水平起调节作用。

Objective To investigate the effect of edaravone adjuvant therapy on neurologic function and free radicals in patients after intracranial aneurysm surgery. Methods A total of 62 cases of intracranial aneurysm who had microscopic clipping surgery from March 2015 to June 2017 in Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University were enrolled. The patients were randomly divided into control group and observation group, with 31 cases in each group. The control group had conventional medication; the observation group was treated with edaravone additionally; both groups were treated for 4 weeks. Therapeutic effect was assessed by Glasgow Outcome Scale（GOS）. Adverse reactions were observed during medication. Neurologic function was assessed by National Institutes of Health Stroke Scale（NIHSS）. Middle cerebral artery blood flow velocity（VMCA） was measured by transcranial Doppler sonography. Serum contents of superoxide dismutase（SOD）, nitric oxide and malonaldehyde were tested. Results 3 months after surgery, the ratio of GOS score=5 was 74.2%（23/31） in the observation group and 58.1%（18/31） in the control group; there was a significant difference between the two groups（P〈0.001）. The incidence rate of complications in the observation group was significantly lower than that in the control group[6.5%（2/31） vs 22.6%（7/31）]（P〈0.001）. On the 14th, 30th day after treatment, NIHSS score and VMCA showed gradual declines; NIHSS score and VMCA in the observation group were significantly lower than those in the control group[5.1±1.4） vs （7.2±1.5）, （3.3±1.3） vs （5.7±1.4）, （83±5）cm/s vs （96±5）cm/s, （74±4）cm/s vs （84±4）cm/s]（P〈0.05）. On the 30th day after treatment, SOD level in the observation group was significantly higher, nitric oxide and malonaldehyde levels were significantly lower than those on the 1st day after treatment and those in the control group（P〈0.05）. Conclusion Adjuvant use of edaravone in patients with intracranial aneurysm surgery can effectively improve the neurologic function and regulate the levels of serum SOD, nitric oxide and malonaldehyde.