依达拉奉右莰醇联合丁苯酞治疗脑梗死的效果及对神经功能的影响

Therapeutic effect of edaravone dexborneol combined with butylphthalide on cerebral infarction and its influence on neurological function

目的评估依达拉奉右莰醇联合丁苯酞对脑梗死的疗效及对神经功能的影响。方法队列研究。抽取2020年10月至2023年10月于郑州颐和医院就诊的72例脑梗死患者,按入院顺序随机分成单药组与联合组,每组36例。单药组给予丁苯酞治疗,联合组给予依达拉奉右莰醇联合丁苯酞治疗。比较两组治疗总有效率及不良反应发生率;比较两组治疗前后神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、日常生活活动能力[Barthel指数(BI)评分]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素1β(IL-1β)]水平、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平、血清神经因子[神经元特异性烯醇化酶(NSE)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)]水平。结果联合组治疗总有效率(91.67%,33/36)高于单药组(72.22%,26/36),P<0.05。治疗后,两组NIHSS评分均降低,BI评分均升高,且联合组NIHSS、BI评分优于单药组(P<0.05)。治疗后,两组血清TNF-α、IL-1β、MDA水平均降低,且联合组TNF-α、IL-1β、MDA水平低于单药组(P<0.05);治疗后,两组SOD水平升高,且联合组高于单药组(P<0.05)。治疗后,两组血清NSE水平均降低,血清NGF、BDNF水平均提高(P均<0.05);治疗后,两组NSE、NGF、BDNF水平比较差异未见统计学意义(P>0.05)。联合组不良反应总发生率(11.11%,4/36)与单药组(8.34%,3/36)比较差异未见统计学意义(P>0.05)。结论依达拉奉右莰醇联合丁苯酞治疗更有助于提高脑梗死患者的治疗有效率,能减轻炎症反应及氧化应激反应,改善神经功能,提升患者生活质量,且不会增加不良反应。

Objective To evaluate the curative effect of edaravone dexborneol combined with butylphthalide on cerebral infarction,and its influence on neurological function.Methods A total of 72 patients with cerebral infarction admitted to Zhengzhou Yihe Hospital from October 2020 to October 2023 were selected for the cohort study.And they were randomly divided into a single-drug group and a combination group according to order of admission,with 36 cases in each group.The single-drug group was treated with butylphthalide,while the combination group was treated with edaravone dexborneol combined with butylphthalide.The total effective rate and incidence of adverse reactions were compared between the two groups.The neurological function assessed by the National Institute of Health stroke scale(NIHSS)score,activities of daily living evaluated by Barthel index(BI)score,levels of inflammatory factors,including tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β),levels of oxidative stress related indicators,including malondialdehyde(MDA)and superoxide dismutase(SOD),and levels of serum nerve factors,including neuron specific enolase(NSE),nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF),were compared between the two groups before and after treatment.Results The total effective rate in the combination group(91.67%,33/36)was significantly higher than that in the single-drug group(72.22%,26/36),P<0.05.After treatment,the NIHSS scores of the two groups significantly decreased,and the BI scores of the two groups significantly increased,moreover,the NIHSS scores and BI scores in the combination group were superior to those in the single-drug group(P<0.05).After treatment,the levels of TNF-α,IL-1βand MDA in the two groups decreased,and the above indexes in the combination group were lower than those in the single-drug group(P<0.05).After treatment,the SOD level in both groups increased,and the combination group had higher SOD level compared with the single-drug group(P<0.05).After treatment,the NSE level in both groups decreased,while the levels of NGF and BDNF increased in both groups(all P<0.05);however,there was no significant difference in postoperative levels of NSE,NGF and BDNF between the two groups(P>0.05).There was no significant differences in the incidence of adverse reactions between the combination group(11.11%,4/36)and the single-drug group(8.34%,3/36),P>0.05.Conclusions Edaravone dexborneol combined with butylphthalide can improve the efficacy in the treatment of cerebral infarction,which can reduce inflammatory reaction and oxidative stress,promote neural functional,and improve the ability of daily life,without increasing adverse reactions.