依达拉奉右莰醇联合阿托伐他汀对急性缺血性脑卒中患者神经功能、血液流变学及iNOS水平的影响

Influences of Edaravone Dexcampol Combined with Atorvastatin on Neurological Function, Hemorheology and iNOS Level in Patients with Acute Ischemic Stroke

目的:观察依达拉奉右莰醇联合阿托伐他汀对急性缺血性脑卒中(AIS)患者神经功能、血液流变学及诱导型一氧化氮合酶(i NOS)水平的影响。方法:纳入2020年10月~2022年6月收治的AIS患者110例,分为2组,对照组(n=54)给予阿托伐他汀治疗,研究组(n=56)给予依达拉奉右莰醇联合阿托伐他汀治疗。比较2组神经功能、血液流变学、氧化应激水平、预后及不良反应,并检测血清一氧化氮(NO)、诱导型一氧化氮合酶(i NOS)、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)水平。结果:治疗2周,两组的美国国立卫生研究院卒中量表(NIHSS)得分、血浆脑钠肽(BNP)检测结果、全血高切黏度(Hηb)、全血低切黏度(Lηb)、血浆黏度(ηp)、iNOS、NSE、GFAP、超氧化物歧化酶(SOD)、丙二醛(MDA)、活性氧簇(ROS)水平均低于治疗前(P <0.05),且研究组低于对照组(P <0.05);两组的NO水平高于治疗前(P <0.05),且研究组高于对照组(P <0.05)。研究组预后良好率高于对照组(76.79%vs 57.41%,P <0.05),不良结局事件总发生率低于对照组(5.36%vs 18.52%,P <0.05),死亡率与对照组差异无统计学意义(1.79%vs 9.26%,P> 0.05),不良反应总发生率与对照组差异亦无统计学意义(8.93%vs 11.11%,P> 0.05)。结论:依达拉奉右莰醇联合阿托伐他汀可改善AIS患者神经功能、血液流变学,减轻氧化应激,调节NO、iNOS、NSE、GFAP水平,减少不良结局,且未明显增加药物不良反应。

Objective: To observe the influences of edaravone dexcampol combined with atorvastatin on neurological function, hemorheology and inducible nitric oxide synthase(iNOS) level in patients with acute ischemic stroke(AIS). Methods: According to the treatment plan, 110 patients with AIS admitted from October 2020 to June 2022 were divided into two groups, patients in the control group( n = 54) received atorvastatin treatment, and patients in the research group(n = 56) received edaravone dexcampol combined with atorvastatin therapy. The neurological function, hemorheology, oxidative stress, prognosis and adverse reactions of the two groups were compared, and serum nitric oxide(NO), iNOS, neuron-specific enolase(NSE) and glial fibrillary acidic protein(GFAP) were detected. Results: After 2 weeks of treatments, the National Institutes of Health Stroke Scale(NIHSS) scores, plasma brain natriuretic peptide(BNP) test results,whole blood high shear viscosities(Hηb), whole blood low shear viscosities(Lηb), plasma viscosities(ηp),serum levels of iNOS, NSE, GFAP, superoxide dismutase(SOD), malondialdehyde(MDA) and reactive oxygen species(ROS) were all lower than those before treatments(P < 0.05), and those of the study group were lower than those of the control group(P < 0.05). After 2 weeks of treatments, serum NO levels in both groups were higher than those before treatment(P < 0.05), and those of the research group were higher than those of the control group(P < 0.05). Comparing with the control group, the study group had a higher good prognosis rate(76.79% vs 57.41%, P < 0.05), a lower total incidence of adverse outcome events(5.36% vs 18.52%, P < 0.05),and similar mortality rate(1.79% vs 9.26%, P > 0.05) and total incidence of adverse reactions(8.93% vs 11.11%, P > 0.05). Conclusion: Edaravone dexcampol combined with atorvastatin could improve neurological function and hemorheology in patients with AIS, reduce oxidative stress, regulate serum levels of NO, iNOS,NSE and GFAP, and reduce adverse outcomes without significantly increasing adverse drug reactions.