丁苯酞对rt-PA静脉溶栓治疗的超早期脑梗死患者氧化损伤和炎症因子的影响

Effects of Butylphthalide on Oxidative Damage and Inflammatory Factors in Patients with Ultra-early Cerebral Infarction Treated by rt-PA Intravenous Thrombolysis

目的探讨丁苯酞对rt-PA静脉溶栓治疗的超早期脑梗死患者氧化损伤和炎症反应的影响。方法选取136例超早期脑梗死患者,随机分为观察组和对照组,每组78例。对照组给予rt-PA静脉溶栓治疗,观察组在溶栓治疗的基础上,加用丁苯酞静脉滴注,对比两组患者溶栓前后24 h、7 d、14 d的NIHSS评估结果并对比两组患者溶栓前、溶栓后24 h、3 d的超氧化歧化酶(SOD)、丙二醇(MDA)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)的检测结果;对比两组患者溶栓前、溶栓后14d的内皮素-1(ET-1)、一氧化氮(NO)检测结果。结果观察组溶栓后24 h、7 d和14 d的NIHSS评分均低于对照组(P均<0.05);观察组溶栓后24 h、3 d的SOD均高于对照组(P均<0.05);观察组溶栓后24 h、3 d的MDA、hs-CRP、TNF-α均低于对照组(P均<0.05)。观察组溶栓14 d后的ET-1、NO均高于对照组(P均<0.05)。结论丁苯酞可减轻rt-PA静脉溶栓治疗后超早期脑梗死患者的氧化损伤,抑制炎症因子的表达,保护血管内皮功能,减轻患者的神经功能缺损症状,提高临床疗效。

Objective To investigate the effect of butylphthalide on oxidative damage and inflammatory response in patients with early cerebral infarction treated by rt-PA intravenous thrombolysis. Methods A total of 136 patients with ultra-early cerebral infarction were randomly divided into observation group and control group with 78 cases in each group. The control group was treated with rt-PA intravenous thrombolysis,while the observation group was treated with butylphthalide intravenous drip on the basis of thrombolysis. The NIHSS before thrombolysis and 24 hours,7 days and 14 days after thrombolysis of the two groups were compared. The results of superoxide dis-mutase(SOD),maleic dialdehyde(MDA),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)before thrombolysis,24 hours and 3 days after thrombolysis of the two groups were compared. The results of endothelin-1(ET-1)and nitric oxide(NO)before thrombolysis and 14 days after thrombolysis of the two groups were compared. Results At 24 hours,7 days and 14 days after thrombolysis,the NIHSS of the observation group were significantly lower than those of the control group(P all<0.05). The SOD of the observation group at 24 hours and 3 days after thrombolysis were significantly higher than those of the control group(P all<0.05). The MDA,hs-CRP and TNF-α of the observation group at 24 hours and 3 days after thrombolysis were significantly lower than those of the control group(P all<0.05). The ET-1 and NO levels of the observation group at 14 days after thrombolysis were significantly lower than those of the control group(P all<0.05). Conclusion Butylphthalide can alleviate oxidative damage,inhibit the expression of inflammatory factors,protect vascular endothelial function,alleviate the symptoms of neurological deficits and improve the clinical efficacy in patients with ultra-early cerebral infarction after rt-PA intravenous thrombolysis.