依达拉奉右莰醇治疗急性脑卒中临床观察

Clinical Observation of Edaravone Dexborneol in the Treatment of Acute Cerebral Infarction

目的探讨依达拉奉右莰醇联合替罗非班对急性脑卒中患者Toll样受体4(TLR4)、核因子-κB(NF-κB)及炎性因子水平的影响。方法选取医院神经内科2021年6月至2022年12月收治的急性脑卒中患者140例,按随机数字表法分为A组、B组、C组和D组,各35例。所有患者均给予常规治疗,A组联用阿司匹林,B组、C组和D组在A组治疗基础上分别加用替罗非班联合依达拉奉右莰醇、替罗非班、依达拉奉右莰醇。4组患者均治疗14 d,随访3个月。结果与A、C、D组比较,B组治疗后的TLR4和NF-κB水平均显著降低(P<0.05),大脑前动脉(ACA)血流速度显著降低(P<0.05),大脑中动脉(MAC)血流速度显著升高(P<0.05),超敏C反应蛋白(hs-CRP)水平及中性粒细胞/淋巴细胞(NLR)均显著降低(P<0.05);B组治疗3个后的美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)评分均显著降低(P<0.05),巴氏量表(Bathel)评分显著升高(P<0.05)。A组、B组、C组、D组的不良反应发生率分别为14.29%,17.14%,11.43%,8.57%,无显著差异(P>0.05)。结论依达拉奉右莰醇联合替罗非班能改善急性脑卒中患者的治疗效果,抑制TLR4/NF-κB信号传导,降低炎性因子水平,有助于脑血流及神经功能恢复,且安全性好。

Objective To investigate the effect of edaravone dexborneol combined with tirofiban on Toll-like receptor 4(TLR4),nuclear factor-κB(NF-κB),and inflammatory cytokine levels in patients with acute cerebral infarction.Methods A total of 140 patients with acute cerebral infarction admitted to the Neurology Department of the hospital from June 2021 to December 2022 were selected and randomly divided into groups A,B,C,D by the random number table method,with 35 cases in each group.All patients were given conventional treatment,on this basis,the patients in group A were treated with aspirin.On the basis of group A,the patients in groups B,C,D were treated with tirofiban combined with edaravone dexborneol,tirofiban,and edaravone dexborneol,respectively.All four groups were treated for 14 d and followed up for three months.Results Compared with those in groups A,C,and D,the TLR4 and NF-κB levels in group B significantly decreased(P<0.05),the blood flow velocity of the anterior cerebral artery(ACA)in group B significantly decreased,the blood flow velocity of the middle cerebral artery(MAC)in group B significantly increased(P<0.05),while the hypersensitive C-reactive protein(hs-CRP)and neutrophil/lymphocyte ratio(NLR)in group B significantly decreased(P<0.05);the National Institutes of Health Stroke Scale(NIHSS)score and the Moeifiet Rankin Scale(mRS)score in group B significantly decreased,while the Bathel score in group B significantly increased after three months of treatment(P<0.05).The incidence rates of adverse reactions in groups A,B,C,and D were 14.29%,17.14%,11.43%and 8.57%respectively,without significant difference(P>0.05).Conclusion Edaravone dexborneol combined with tirofiban in the treatment of patients with acute cerebral infarction can improve the therapeutic effect,inhibit TLR4/NF-κB signal transduction,reduce levels of inflammatory factors,promote the recovery of cerebral blood flow and neurological function,and it has good safety.