依达拉奉对急性脑梗死患者脑电活动的影响

Impact of Edaravone on Brain Electrical Activity in Patients with Acute Cerebral Infarction

目的 探讨依达拉奉对急性脑梗死(ACI)患者脑电活动的影响。方法 选取2016年9月—2017年12月钦州市第一人民医院收治的ACI患者100例,采用随机数字表法分为对照组和试验组,每组50例;后对照组患者中脱落10例,试验组患者中脱落4例。对照组患者给予常规治疗,试验组患者在常规治疗基础上给予依达拉奉治疗;两组患者均连续治疗14d。比较两组患者入院24h内、治疗7d、治疗14d健侧、患侧、整体δ及θ频段绝对功率值、慢波化比率(DTABR),美国国立卫生研究院卒中量表(NIHSS)评分,Barthel指数评分;DTABR与ACI患者NIHSS评分的相关性分析采用Pearson相关分析;观察两组患者治疗期间药物不良反应发生情况。结果 (1)时间与方法在健侧、患侧、整体δ频段绝对功率值上存在交互作用(P<0.05);时间、方法在健侧、患侧、整体δ频段绝对功率值上主效应显著(P<0.05)。治疗后14d试验组患者健侧、患侧、整体δ频段绝对功率值低于对照组(P<0.05)。(2)时间与方法在健侧、患侧、整体θ频段绝对功率值上不存在交互作用(P>0.05);时间、方法在健侧、患侧、整体θ频段绝对功率值上主效应显著(P<0.05)。试验组患者治疗7d健侧、患侧、整体θ频段绝对功率值低于对照组(P<0.05)。(3)时间与方法在健侧、患侧、整体DTABR上存在交互作用(P<0.05);时间、方法在健侧、患侧、整体DTABR上主效应显著(P<0.05)。试验组患者治疗后7d、14d健侧、患侧、整体DTABR低于对照组(P<0.05)。(4)时间与方法在NIHSS评分上存在交互作用(P<0.05),在Barthel指数评分上不存在交互作用(P>0.05);时间、方法在NIHSS评分和Barthel指数评分上主效应显著(P<0.05)。试验组患者治疗7d、14dNIHSS评分低于对照组,治疗14dBarthel指数评分高于对照组(P<0.05)。(5)Pearson相关分析结果显示,DTABR与ACI患者NIHSS评分呈正相关(r=0.936,P=0.021)。(6)两组患者治疗期间药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论 依达拉奉可有效降低ACI患者δ及θ频段绝对功率值、DTABR、NIHSS评分,提高ACI患者Barthel指数评分,且安全性较高,有利于改善脑微循环、神经功能,缓解脑水肿,提高患者生活质量。

Objective To investigate the impact of edaravone on brain electrical activity in patients with acute cerebral infarction(ACI).Methods A total of 100 patients with ACI were selected in the First People's Hospital of Qinzhou from September 2016 to December 2017,and they were divided into control group and test group,with 50 cases in each group;after that 10 cases in control group and 4 cases in test group fell off from this study.Patients in control group received conventional treatment,while patients in test group received extra edaravone based on conventional treatment;both groups continuously treated for 14 days.Absolute power value ofδfrequency band andθfrequency band,and(θ+δ)/(α+β)ratio(DTABR)in normal side,affected side and entirety,NIHSS score and Barthel index were compared between the two groups within 24 hours after admission,7 and 14 days after treatment;Pearson correlation analysis was used to analyze the correlation between DTABR and NIHSS score in patients with ACI;incidence of adverse drug reactions was observed during treatment.Results(1)There was statistically significant interaction in absolute power value ofδfrequency band in normal side,affected side and entirety between time and method(P<0.05);main effects of time and method were statistically significant in absolute power value ofδfrequency band in normal side,affected side and entirety(P<0.05).Absolute power value ofδfrequency band in normal side,affected side and entirety in test group was statistically significantly lower than that in control group 14 days after treatment,respectively(P<0.05).(2)There was no statistically significant interation in absolute power value ofθfrequency band in normal side,affected side and entirety between time and method(P>0.05);main effects of time and method were statistically significant in absolute power value ofθfrequency band in normal side,affected side and entirety(P<0.05).Absolute power value ofθfrequency band in normal side,affected side and entirety in test group was statistically significantly lower than that in control group 7 days after treatment,respectively(P<0.05).(3)There was statistically significant interaction in DTABR in normal side,affected side and entirety between time and method(P<0.05);main effects of time and method were statistically significant in DTABR in normal side,affected side and entirety(P<0.05).DTABR in normal side,affected side and entirety in test group was statistically significantly lower than that in control group 7 and 14 days after treatment,respectively(P<0.05).(4)There was statistically significant interaction in NIHSS score between time and method(P<0.05),but no statistically significant interaction was found in Barthel index between time and method(P>0.05);main effects of time and method were statistically significant in NIHSS score and Barthel index(P<0.05).NIHSS score in test group was statistically significantly lower than that in control group 7 and 14 days after treatment,respectively,while Barthel index in test group was statistically significantly higher than that in control 14 days after treatment(P<0.05).(5)Pearson correlation analysis results showed that,DTABR was positively correlated with NIHSS score in patients with ACI(r=0.936,P=0.021).(6)No statistically significant difference of incidence of adverse drug reactions was found between the two groups during treatment(P>0.05).Conclusion Edaravone can effectively reduce the absolute power value ofδfrequency band andθfrequency band,DTABR and NIHSS score,improve the Barthel index,with relatively high safety,thus it is helpful to improve the cerebral microcirculation,neurological function and quality of life,relieve the encephaledema.