依达拉奉注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的效果观察

Effects of edaravone injection combined with alteplase intravenous thrombolysis on patients with acute ischemic stroke

目的探讨依达拉奉注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中(AIS)的效果。方法抽取2019年1月至2021年1月新乡市中心医院收治的AIS患者82例,依据随机数字表法分为观察组41例与对照组41例。对照组给予阿替普酶静脉溶栓治疗,观察组在对照组基础上联合依达拉奉注射液治疗。两组疗程均为2周。比较两组治疗效果,治疗前与治疗2周美国国立卫生院神经功能缺损程度评分量表(NIHSS)评分、日常生活活动能力(ADL)评分、脑血流动力学、氧化应激、血清氧化型低密度脂蛋白(Ox-LDL)和缺血修饰白蛋白(IMA)水平变化。结果观察组总有效率(90.24%)高于对照组(70.73%),P<0.05。两组治疗2周NIHSS评分低于治疗前,而ADL评分高于治疗前(P<0.05);观察组治疗2周NIHSS评分低于对照组,而ADL评分高于对照组(P<0.05)。两组治疗2周双侧大脑中动脉的峰流速(Vp)和平均流速(Vm)高于治疗前(P<0.05);观察组治疗2周Vp和Vm高于对照组(P<0.05)。两组治疗2周超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平高于治疗前,而丙二醛(MDA)水平低于治疗前(P<0.05);观察组治疗2周SOD和GSH-Px水平高于对照组,而MDA水平低于对照组(P<0.05)。两组治疗2周血清Ox-LDL和IMA水平与治疗前比较,P<0.05;观察组治疗2周AIS患者血清Ox-LDL和IMA水平与对照组比较,P<0.05。结论依达拉奉注射液与阿替普酶静脉溶栓联用对AIS患者疗效良好,可改善患者氧化应激水平,降低Ox-LDL和IMA水平。

Objective To investigate the effect of edaravone injection and alteplase intravenous thrombolysis on patients with acute ischemic stroke(AIS).Methods A total of 82 patients with AIS in Xinxiang Central Hospital from January 2019 to January 2021 were selected,and divided into observation group(41 cases)and control group(41 cases)according to the random number table method.Patients in the control group were given intravenous thrombolysis with alteplase,and the observation group was treated with edaravone injection on the basis of the control group.The course of treatment for both groups was 2 weeks.The therapeutic effects of the two groups were compared,and the changes in National Institutes of Health Stroke Scale(NIHSS)score and activities of daily living(ADL)score,cerebral hemodynamics,oxidative stress,levels of oxidized low-density lipoprotein(Ox-LDL)and ischemia modified albumin(IMA)in serum before and 2 weeks after treatment were compared.Results The total effective rate in the observation group(90.24%)was higher than 70.73%of the control group,P<0.05.The NIHSS score in the two groups was lower than that before treatment for 2 weeks,while the ADL score of the two groups was higher than that before treatment(P<0.05);the observation group was treated for 2 weeks and the NIHSS score was lower than that of the control group,while the ADL score was higher than that of the control group(P<0.05).The peak velocity(Vp)and average velocity(Vm)in the two groups after 2 weeks of treatment were higher than those before treatment(P<0.05);the Vp and Vm of the observation group were higher than the that of control group after 2 weeks of treatment(P<0.05).The levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)of the two groups were higher than those before treatment,while the levels of malondialdehyde(MDA)were lower than those before treatment(P<0.05);the SOD and GSH-Px levels of AIS patients in the observation group were higher than that of control group after 2 weeks of treatment.The MDA level was lower the control group(P<0.05).The levels of serum Ox-LDL and IMA of the two groups after 2 weeks of treatment were compared with those before treatment,P<0.05;the levels of serum Ox-LDL and IMA of the observation group were compared with those of the control group,P<0.05.Conclusions The combined application of edaravone injection and alteplase intravenous thrombolysis has a good effect on patients with AIS,it can improve the level of oxidative stress in patients,and reduce the levels of Ox-LDL and IMA.