依达拉奉右莰醇注射用浓溶液联合己酮可可碱治疗急性脑梗死的临床研究

Clinical study of Edaravone and Dexborneol Concentrated Solution for injection combined with pentoxifylline in treatment of acute cerebral infarction

目的 探讨依达拉奉右莰醇注射用浓溶液联合己酮可可碱注射液治疗急性脑梗死的临床疗效。方法 2021年4月1日—2022年4月30日在溧阳人民医院接受治疗的150例急性脑梗死患者,按照使用药物的差别分为对照组和治疗组,每组各75例。对照组静脉泵入己酮可可碱注射液,将0.2 g己酮可可碱注射液同0.9%氯化钠注射液250 mL配伍,1次/d。治疗组在对照组基础上静脉滴注依达拉奉右莰醇注射用浓溶液,15 mL同0.9%氯化钠注射液100 mL配伍,2次/d。两组患者均经14 d治疗。观察两组的临床疗效,比较两组治疗前后美国国立卫生院卒中量表(NIHSS)评分、改良Rankin量表(MRS)评分、大脑中动脉(MCA)供血区缺血改变量表(DWI-ASPECTS)评分、功能独立性评测量表(FIM)评分、日常生活活动能力量表(ADL)评分、血清细胞因子、血液流变学指标的变化情况。结果 治疗后,治疗组总有效率为96.00%,显著高于对照组的81.33%,差异具有统计学意义(P<0.05)。治疗后,两组NIHSS评分、MRS评分均较治疗前显著降低,而DWI-ASPECTS评分、FIM评分、ADL评分均较治疗前显著升高(P<0.05);并以治疗组改善更为明显(P<0.05)。治疗后,两组血清超敏C反应蛋白(hc-CRP)、尿酸(UA)、白细胞介素-6(IL-6)、半胱氨酸(Hcy)、肿瘤坏死因子-α(TNF-α)水平均较治疗前显著降低,且治疗组改善更明显(P<0.05)。治疗后,两组纤维蛋白原(FIB)、红细胞压积(HCT)均较治疗前显著降低,而活化部分凝血活酶时间(APTT)显著延长(P<0.05),且治疗后,治疗组血液流变学指标改善更明显(P<0.05)。结论 依达拉奉右莰醇注射用浓溶液联合己酮可可碱注射液治疗急性脑梗死具有较好的临床疗效,可有效促进患者神经功能恢复,提高患者日常生活活动能力,改善血清细胞因子和血液流变学指标,有着良好的临床应用价值。

Objective To investigate the clinical efficacy of Edaravone and Dexborneol Concentrated Solution for injection combined with pentoxifylline in treatment of acute cerebral infarction. Methods A total of 150 patients with acute cerebral infarction who received treatment in Liyang People’s Hospital from April 1, 2021 to April 30, 2022 were divided into control group and treatment group according to the difference of drugs used, with 75 cases in each group. Patients in the control group were intravenously pumped with Pentoxifylline Injection, 0.2 g Pentoxifylline Injection was mixed with 0.9% sodium chloride injection 250 mL, once daily.Patients in the treatment group were iv administered with Edaravone and Dexborneol Concentrated Solution for injection on the basis of control group, 15 mL in combination with 0.9% Sodium chloride injection 100 mL, twice daily. Both groups were treated for 14 d. The clinical efficacy of the two groups was observed, and changes of NIHSS score, MRS score, DWI-ASPECTS score, FIM score, ADL score,serum cytokines, and hemorheological indexes in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.00%, which was significantly higher than that of the control group(81.33%), and the difference was statistically significant(P < 0.05). After treatment, NIHSS score and MRS Score were significantly decreased compared with before treatment, while DWI-ASPECTS score, FIM score and ADL score were significantly increased compared with before treatment(P < 0.05). The improvement was more obvious in the treatment group(P < 0.05). After treatment, serum levels of hypersensitive C-reactive protein(hc-CRP), uric acid(UA), interleukin-6(IL-6), cysteine(Hcy) and tumor necrosis factor-α(TNF-α) in 2 groups were significantly decreased compared with before treatment, and the improvement was more obvious in treatment group(P < 0.05). After treatment, fibrinogen(FIB) and hematopoietic volume(HCT) were significantly decreased in both groups, while activated partial thrombin time(APTT) was significantly prolonged(P < 0.05). After treatment, hemorheology indexes were improved more significantly in the treatment group(P < 0.05). Conclusion Edaravone and Dexborneol Concentrated Solution for injection combined with pentoxifylline has good clinical effect in treatment of acute cerebral infarction, and can effectively promote the recovery of neurological function, improve patients’ ability of daily living activities, improve serum cytokines and hemorheology indexes, which has good clinical application value.