依达拉奉右莰醇联合阿替普酶治疗急性脑梗死的疗效

Efficacy of edaravone dexcamphor combined with alteplase in the treatment of ACI

目的观察依达拉奉右莰醇联合阿替普酶治疗急性脑梗死(ACI)的疗效。方法选取2021年6月—2022年12月景德镇市第一人民医院神经内科收治的ACI患者120例,以随机数字表法分为试验组(n=60)和对照组(n=60)。试验组予依达拉奉右莰醇+阿替普酶静脉溶栓治疗,对照组予阿替普酶静脉溶栓治疗,2组均治疗2周。比较2组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、炎性因子[C反应蛋白(CRP)、白介素-6(IL-6)]水平及不良反应,随访3个月,比较2组继发性出血事件及预后。结果试验组总有效率为91.67%,高于对照组的78.33%(χ^(2)=4.183,P=0.041)。溶栓后1 h、24 h、14 d,2组NIHSS评分较溶栓前逐渐降低,且试验组低于对照组(P均<0.01);治疗2周后,2组CRP、IL-6水平低于治疗前,且试验组低于对照组(P均<0.01)。试验组与对照组不良反应总发生率比较差异无统计学意义(13.33%vs.6.67%,χ^(2)=1.482,P=0.224)。随访3个月,2组继发性出血事件总发生率比较差异无统计学意义(P>0.05);试验组mRS评分、病死率均低于对照组(P<0.05或P<0.01)。结论依达拉奉右莰醇联合阿替普酶静脉溶栓治疗ACI的效果更为显著,可有效改善患者神经功能,缓解炎性反应、降低患者病死率,安全性较高。

Objective To observe the efficacy of edaravone dexcamphor combined with alteplase in the treatment of ACI.Methods A total of 120 patients with ACI admitted to the department of neurology,Jingdezhen NO.1 People′s Hospital from June 2021 to December 2022 were selected and randomly divided into the experimental group(n=60)and the control group(n=60).The experimental group was treated with edaravone dexcamphor+alteplase intravenous thrombolysis,and the control group was treated with alteplase intravenous thrombolysis.Both groups were treated for 2 weeks.The clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)score,inflammatory factors(CRP,IL-6)levels and adverse reactions were compared between the two groups.The patients were followed up for 3 months,and the secondary bleeding events and prognosis were compared between the two groups.Results The total effective rate of the experimental group was 91.67%,which was higher than 78.33%of the control group(χ^(2)=4.183,P=0.041).At 1,24 hours and 14 days after thrombolysis,the NIHSS scores of the two groups gradually decreased compared with those before thrombolysis,and those in the experimental group were lower than those in the control group(P<0.01).After 2 weeks of treatment,the levels of CRP and IL-6 in the two groups were lower than those before treatment,and those in the experimental group were lower than those in the control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the experimental group and the control group(13.33%vs.6.67%,χ^(2)=1.482,P=0.224).After 3 months of follow-up,there was no significant difference in the total incidence of secondary bleeding between the two groups(P>0.05).The mRS score and mortality of the experimental group were lower than those of the control group(P<0.05 or P<0.01).Conclusion Edaravone dexcamphor combined with alteplase intravenous thrombolysis in the treatment of ACI has a more significant effect,which can effectively improve the neurological function of patients,relieve inflammatory reaction,reduce the mortality of patients,and has a high safety.