依达拉奉右莰醇联合阿加曲班治疗超溶栓时间窗缺血性卒中52例的疗效及对炎症反应、氧化应激的影响

Efficacy of Edaravone and Dexborneol Combined with Argatroban in the Treatment of 52 Cases of Ischemic Stroke Patients Beyond the Thrombolytic Time Window and Its Effects on Inflammation and Oxidative Stress

目的 研究依达拉奉右莰醇联合阿加曲班治疗超溶栓时间窗缺血性卒中患者的临床效果及对炎症反应、氧化应激的影响。方法 根据治疗方法不同将2020年12月至2022年12月许昌市立医院超溶栓时间窗缺血性卒中患者104例分为对照组、联合组,各52例。对照组采用阿加曲班治疗,联合组采用依达拉奉右莰醇联合阿加曲班治疗,两组均持续治疗14 d。比较两组临床疗效,凝血功能[活化凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)],氧化应激指标[活性氧簇(ROS)、丙二醛(MDA)、超氧化物歧化酶(SOD)],神经功能指标[美国国立卫生研究院卒中量表(NIHSS)、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)],炎症因子[肿瘤坏死因子-α(TNF-α)、脂蛋白相关磷脂酶A2(Lp-PLA2)、白细胞介素-6(IL-6)]。结果 联合组临床总有效率为86.54%,高于对照组69.23%,差异有统计学意义(P<0.05);与对照组相比,治疗后联合组APTT、PT、FIB、TT较低,差异有统计学意义(P<0.05);治疗后联合组ROS、MDA、SOD降低幅度大于对照组,差异有统计学意义(P<0.05);治疗后联合组NIHSS评分、MBP、NSE低于对照组,差异有统计学意义(P<0.05);与对照组相比,治疗后联合组TNF-α、Lp-PLA2、IL-6明显降低,差异有统计学意义(P<0.05)。结论 依达拉奉右莰醇联合阿加曲班治疗超溶栓时间窗缺血性卒中患者疗效确切,可改善凝血功能,缓解氧化应激、炎症反应,修复神经缺损。

Objective To investigate the clinical effect of edaravone and dexborneol combined with argatroban in the treatment of ischemic stroke(IS)patients beyond the thrombolytic time window and its effects on inflammation and oxidative stress.Methods According to different treatment methods,104 patients beyond the thrombolytic time window IS in Xuchang Municipal Hospital from December 2020 to December 2022 were divided into control group and combination group,with 52 cases in each group.The control group was treated with argatroban,and the combination group was treated with edaravone and dexborneol combined with argatroban.The clinical efficacy,coagulation function[activated thrombin time(APTT),prothrombin time(PT),fibrinogen(FIB),thrombin time(TT)],oxidative stress[reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD)],neurological function[National Institutes of Health Stroke Scale(NIHSS),myelin basic protein(MBP),neuron specific enolase(NSE)],inflammatory factors[tumor necrosis factor-α(TNF-α),lipoprotein-associated phospholipase A2(Lp-PLA2),interleukin-6(IL-6)]were compared between the two groups.Results The total clinical effective rate of the combined group was 86.54%,higher than that of the control group 69.23%,the difference was statistically significant(P<0.05).Compared with control group,APTT,PT,FIB and TT in combination group were lower after treatment,the difference was statistically significant(P<0.05).After treatment,ROS,MDA and SOD in combination group decreased more than that in control group;NIHSS score,MBP and NSE in combination group were lower than those in control group;the difference were statistically significant(P<0.05).Compared with control group,TNF-α,Lp-PLA2 and IL-6 in combination group were significantly decreased after treatment,the difference was statistically significant(P<0.05).Conclusion Edaravone and dexborneol combined with argatroban is effective in the treatment of IS patients beyond the thrombolytic time window.It can improve coagulation function,relieve oxidative stress and inflammation,and repair nerve defects.