依达拉奉右莰醇联合尿激酶静脉溶栓治疗急性脑梗死合并糖尿病对患者血清氧化应激水平、颈总动脉内-中膜厚度、血清基质金属蛋白酶-12水平的影响

Effects of edaravone dexborneol combined with urokinase intravenous thrombolysis on serum oxidative stress,common carotid artery intra-media thickness and serum MMP-12 in patients with acute cerebral infarction and diabetes mellitus

目的:研究依达拉奉右莰醇联合尿激酶静脉溶栓对急性脑梗死(ACI)合并糖尿病患者血清氧化应激水平、颈总动脉内-中膜厚度(IMT)、血清基质金属蛋白酶-12(MMP-12)水平的影响。方法:选取90例ACI合并糖尿病患者随机分为溶栓组和抗氧化组,每组各45例,溶栓组患者在常规治疗基础上使用尿激酶静脉溶栓治疗,抗氧化组使用依达拉奉右莰醇联合尿激酶静脉溶栓治疗,两组患者均治疗2周,比较两组患者治疗前和治疗2周后神经功能[美国国立卫生研究院卒中量表(NIHSS)]、脑血流动力学指标[最小血流量(Qmin)、最小血流速度(Vmin)]、颈动脉超声指标[IMT、颈总动脉收缩期内径(Ds)、颈总动脉舒张期内径(Dd)]、血清氧化应激水平[丙二醛(MDA)、超氧化物歧化酶(SOD)、去甲肾上腺素(NE)]、炎症指标[C反应蛋白(CRP)、MMP-12、血清基质金属蛋白酶-9(MMP-9)]。比较治疗2周内两组患者药物不良反应发生率。结果:治疗2周后,两组患者Qmin、Vmin、SOD水平显然高于治疗前,抗氧化组显著高于溶栓组(均P<0.05);MDA、NE、IMT、Ds、Dd、CRP、MMP-12、MMP-9水平和NIHSS评分显然低于治疗前,抗氧化组显著低于溶栓组(均P<0.05)。治疗2周内,两组药物不良反应发生率比较无统计学差异(P>0.05)。结论:依达拉奉右莰醇联合尿激酶静脉溶栓治疗ACI合并糖尿病患者可有效缓解患者机体氧化应激反应,改善脑部血流和颈动脉超声指标,且安全性良好。

Objective:To study the effects of edaravone dexborneol combined with urokinase intravenous thrombolysis on serum oxidative stress level,common carotid artery intra-media thickness(IMT)and serum matrix metalloproteinase-12(MMP-12)level in patients with acute cerebral infarction(ACI)complicated with diabetes mellitus.Methods:90 patients with ACI and diabetes mellitus were selected and randomly divided into thrombolysis group and antioxidation group,with 45 cases in each group.The thrombolysis group was given urokinase intravenous thrombolysis on the basis of conventional treatment,and the antioxidation group was treated with edaravone dexborneol combined with urokinase intravenous thrombolysis,and both groups were treated for 2 weeks.The neurological function indicator[National Institutes of Health Stroke Scale(NIHSS)],cerebral hemodynamic indicators[minimum blood flow volume(Qmin),minimum blood flow velocity(Vmin)],carotid ultrasound indicators[common carotid artery intra-media thickness(IMT),common carotid artery systolic diameter(Ds),common carotid artery diastolic diameter(Dd)],serum oxidative stress indicators[Malondialdehyde(MDA),Superoxide dismutase(SOD),norepinephrine(NE)]and inflammatory indicators[C-reactive protein(CRP),MMP-12,MMP-9]of the two groups before treatment and after 2 weeks of treatment were compared.The incidence rates of adverse drug reactions within 2 weeks of treatment were compared between the two groups.Results:After 2 weeks of treatment,the Qmin,Vmin and SOD of the two groups were significantly higher than those before treatment,and the three indicators of antioxidation group were significantly higher than those of thrombolysis group(all P<0.05).The MDA,NE,IMT,Ds,Dd,CRP,MMP-12,MMP-9 and NIHSS score were obviously lower than those before treatment,and the above indicators in antioxidation group were significantly lower than those in thrombolysis group(all P<0.05).Within 2 weeks of treatment,there were no significant differences in the incidence rates of adverse drug reactions between the two groups(all P>0.05).Conclusion:Edaravone dexborneol combined with urokinase intravenous thrombolysis for patients with ACI and diabetes mellitus can effectively alleviate the body’s oxidative stress response,and improve the cerebral blood flow and carotid ultrasound parameters,with good safety.