摘要
目的研究依达拉奉右莰醇注射液对急性前循环脑梗死血管介入术后开通良好患者的脑保护作用。方法选择2022年6月至2023年6月延安大学附属医院收治的98例急性前循环脑梗死血管介入术后(支架取栓+中间导管抽吸术)开通良好的患者作为研究对象,按随机数表法将患者分为观察组和对照组,每组49例,对照组患者给予抗凝、抗感染及神经营养等常规治疗,观察组患者在对照组基础上采用依达拉奉右莰醇注射液治疗,均连续治疗两周。比较两组患者的治疗效果,以及治疗前后的氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、活性氧簇(ROS)]、炎性因子指标[C反应蛋白(hs-CRP)、脂蛋白相关磷脂酶A2(Lp-PLA2)、五聚素3(PTX3)]、神经功能缺损(NIHSS)评分及改良Rankin(MRS)评分,比较两组患者治疗期间的不良反应情况。结果治疗后,观察组患者的治疗总有效率为91.84%,明显高于对照组的71.43%,差异有统计学意义(P<0.05);治疗前,两组患者的MDA、SOD、ROS水平比较差异均无统计学意义(P>0.05),治疗后,两组患者的MDA、SOD、ROS水平均明显降低,且观察组分别为(39.81±3.26)μmol/L、(122.67±9.35)U/mL、(453.98±10.86)μmol/L,明显低于对照组的(46.87±5.31)μmol/L、(142.96±12.37)U/mL、(506.72±12.67)μmol/L,差异均有统计学意义(P<0.05);治疗前,两组患者的hs-CRP、LP-PLA2、PTX3水平比较差异均无统计学意义(P>0.05),治疗后,两组患者的hs-CRP、LP-PLA2、PTX3水平均明显降低,且观察组分别为(9.58±1.23)mg/L、(7.30±2.16)μg/L、(2.85±0.91)ng/L,明显低于对照组的(15.67±2.39)mg/L、(9.86±2.85)μg/L、(5.37±1.06)ng/L,差异均有统计学意义(P<0.05);治疗前,两组患者的NIHSS、MRS评分比较差异均无统计学意义(P>0.05),治疗后,两组患者的NIHSS、MRS评分均明显降低,且观察组分别为(3.21±0.36)分、(1.96±0.32)分,明显低于对照组的(7.68±1.87)分、(2.37±0.80)分,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为8.16%,略低于对照组的14.29%,但差异无统计学意义(P>0.05)。结论依达拉奉右莰醇注射液可有效改善急性前循环脑梗死患者血管介入术后的脑神经,减少炎症反应及氧化应激反应,不良反应少,可在临床推广应用。
Objective To study the neuroprotective effect of Edaravone Dexborneol Injection on patients with acute anterior circulation cerebral infarction who have good patency after vascular intervention surgery.Methods Ninety-eight patients with acute anterior circulation cerebral infarction who received vascular intervention(stent thrombectomy+intermediate catheter aspiration)from June 2022 to June 2023 at Yan'an University Affiliated Hospital were selected as the study subjects.According to random number table method,they were divided into a study group and a control group,each with 49 cases.Patients in the control group received conventional treatment such as anticoagulation,anti-infection,and neurotrophic therapy,and those in the study group were treated with Edaravone Dexborneol Injection on the basis of the control group,continuously for 2 weeks.The total effective rate of treatment was compared between the two groups of patients,including oxidative stress indicators such as malondialdehyde(MDA),superoxide dismutase(SOD),reactive oxygen species(ROS),inflammatory factor indicators such as C-reactive protein(hs-CRP),lipoprotein related phospholipase A2(Lp-PLA2),pentameric protein 3(PTX3),neurological deficit(NIHSS)score,and modified Rankin(MRS)score before and after 2 weeks of treatment.The adverse reactions during treatment were also compared.Results After treatment,the total effective rate of the study group was 91.84%,which was significantly higher than 71.43%in the control group(P<0.05).Before treatment,there was no statistically significant difference in the levels of MDA,SOD,and ROS between the two groups of patients(P>0.05);after treatment,the levels of MDA,SOD,and ROS in both groups of patients were significantly reduced,and the levels in the study group were(39.81±3.26)μmol/L,(122.67±9.35)U/mL,(453.98±10.86)μmol/L,which were significantly lower than(46.87±5.31)μmol/L,(142.96±12.37)U/mL,(506.72±12.67)μmol/L in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in the levels of hs-CRP,LP-PLA2,and PTX3 between the two groups(P>0.05);after treatment,the levels of hs-CRP,LP-PLA2,and PTX3 in the two groups were significantly reduced,and the levels in the study group were(9.58±1.23)mg/L,(7.30±2.16)μg/L,(2.85±0.91)ng/L,which were significantly lower than(15.67±2.39)mg/L,(9.86±2.85)μg/L,(5.37±1.06)ng/L in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in the NIHSS and MRS scores between the two groups of patients(P>0.05);after treatment,the NIHSS and MRS scores of the two groups were significantly reduced,and the scores in the study group were(3.21±0.36)points,(1.96±0.32)points,which were significantly lower than(7.68±1.87)points,(2.37±0.80)points in the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the observation group was 8.16%,which was slightly lower than 14.29%in the control group(P>0.05).Conclusion Edaravone Dexborneol Injection can effectively improve the cerebral nerves of patients with acute anterior circulation cerebral infarction after vascular intervention,reduce inflammatory and oxidative stress reactions,and have fewer adverse reactions.It can be widely applied in clinical practice.
作者
高亚军
宋倩
刘春霞
吴瑞
郭改艳
GAO Ya-jun;SONG Qian;LIU Chun-xia;WU Rui;GUO Gai-yan(Department of Neurology,Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi,CHINA;Department of Clinical Laboratory,Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi,CHINA;Department of Radiology,Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第24期3513-3517,共5页
Hainan Medical Journal
基金
陕西省重点研发计划项目(编号:2017SF-223)。
关键词
急性前循环
脑梗死
依达拉奉右莰醇
脑保护
血管介入术
神经功能
Acute anterior circulation
Cerebral infarction
Edaravone Dexborneol Injection
Brain protection
Vascular intervention surgery
Neurological function