依达拉奉联合阿替普酶对急性缺血性脑卒中患者炎性因子、氧化应激及免疫功能的影响

Effects of edaravone combined with alteplase on the inflammatory cytokines,oxidative stress and immune function in patients with acute ischemic cerebral stroke

目的研究依达拉奉联合阿替普酶对急性缺血性脑卒中(AIS)患者炎性因子、氧化应激及免疫功能的影响。方法将2017年1月至2020年7月确诊并接受治疗的92例AIS患者纳入研究范围,分为对照组和联合组,每组46例。对照组接受注射用阿替普酶治疗,联合组在对照组基础上加用依达拉奉治疗。疗程均为2周。观察2组炎性因子[白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、T淋巴细胞亚群(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、免疫球蛋白[免疫球蛋白A(IgA)、IgG、IgM]、红细胞免疫指标[红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)]变化。结果治疗前,2组IL-6、TNF-α、hs-CRP、SOD、MDA、CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)、IgA、IgG、IgM、RBC-C3bRR、RBC-ICR差异无统计学意义(P>0.05);治疗后,2组IL-6、TNF-α、hs-CRP、MDA、CD_(8)^(+)、RBC-ICR显著低于治疗前(P<0.05),SOD、CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、IgA、IgG、IgM、RBC-C3bRR显著高于治疗前(P<0.05);与对照组比较,联合组IL-6、TNF-α、hs-CRP、MDA、CD_(8)^(+)、RBC-ICR显著降低(P<0.05),SOD、CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、IgA、IgG、IgM、RBC-C3bRR显著升高(P<0.05)。结论依达拉奉联合阿替普酶治疗AIS能够减轻炎性反应和氧化应激反应,提高患者免疫功能。

Objective To investigate the effects of edaravone combined with alteplase on the inflammatory cytokines,oxidative stress and immune function in patients with acute ischemic cerebral stroke(AIS).Methods A total of 92 patients with AIS who were treated in our hospital from January 2017 to July 2020 were enrolled in the study,who were randomly divided into control group and combination treatment group,with 46 cases in each group.The patients in control group were treated by intravenous thrombolysis with alteplase,however,those in combination treatment group,on the basis of control group,were treated by edaravone,with a treatment course of 2 weeks for both groups.After treatment,the levels of inflammatory cytokines(IL-6,TNF-αand hs-CRP),oxidative stress(SOD and MDA),T lymphocytes subsets(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+) and CD_(4)^(+)/CD_(8)^(+)),immunoglobulin(IgA,IgG and IgM)and erythrocyte immune function(RBC-C3bRR and RBC-ICR)were observed and compared between the two groups.Results Before treatment,there were no significant differences in the levels of IL-6,TNF-α,hs-CRP,SOD,MDA,CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),IgA,IgG,IgM,RBC-C3bRR and RBC-ICR between the two groups(P>0.05).After treatment,the levels of IL-6,TNF-α,hs-CRP,MDA,CD_(8)^(+) and RBC-ICR in both groups were significantly decreased(P<0.05),however,the levels of SOD,CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),IgA,IgG,IgM and RBC-C3bRR were significantly increased(P<0.05).Moreover the decrease degree and increase degree in combination treatment group were more significant than those in control group(P<0.05).Conclusion The edaravone combined with alteplase in treatment of AIS can significantly alleviate the inflammatory reaction and oxidative stress,and improve the immune function of patients.