依达拉奉右莰醇联合阿替普酶溶栓对急性脑梗死患者脑血流灌注与氧化应激及神经功能的影响

Effect of edaravone and dextranol combined with alteplase thrombolysis on cerebral blood flow perfusion,oxidative stress and neurological function in patients with acute cerebral infarction

目的 观察依达拉奉右莰醇联合阿替普酶溶栓对急性脑梗死患者脑血流灌注与氧化应激及神经功能的影响。方法 以随机数字表法将2019年8月—2022年12月泉州德诚医院收治的急性脑梗死患者63例进行分组,分为阿替普酶组(31例)和联合溶栓组(32例)。阿替普酶组给予阿替普酶静脉溶栓治疗,联合溶栓组在阿替普酶组基础上予依达拉奉右莰醇治疗,2组均持续治疗14 d。比较2组治疗前后脑血流灌注情况、氧化应激指标[血清谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、超氧化物歧化酶(SOD)]、神经功能指标[血清神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100-β)],不良反应。结果 治疗14 d后,2组收缩期血流速度、平均血流速度、脑血管储备功能较治疗前升高,搏动指数较治疗前下降,且联合溶栓组升高/下降幅度大于阿替普酶组(P均<0.01);2组血清GSH-Px、SOD水平升高,血清MDA、NSE、S100-β水平降低,且联合溶栓组升高/降低幅度大于阿替普酶组(P<0.05或P<0.01)。联合溶栓组不良反应总发生率为15.64%,与阿替普酶组的19.35%比较,差异无统计学意义(χ^(2)=0.152,P=0.697)。结论 依达拉奉右莰醇联合阿替普酶溶栓治疗急性脑梗死患者具有良好疗效,有利于增强脑部血液供应,缓解机体氧化应激反应,改善神经功能,且不良反应较少,安全性高。

Objective To observe the effect of edaravone and dextranol combined with alteplase thrombolysis on cerebral blood flow perfusion,oxidative stress and neurological function in patients with acute cerebral infarction.Methods A total of 63 patients with acute cerebral infarction admitted to Quanzhou Decheng Hospital from August 2019 to December 2022 were divided into the alteplase group(31 cases) and the combined thrombolysis group(32 cases) by random number table method.The alteplase group was treated with alteplase thrombolytic therapy,and the combined thrombolysis group was treated with edaravone and dextranol on the basis of alteplase group,and two groups were continuously treated for 14 days.Cerebral blood flow perfusion,oxidative stress indexes(GSH-Px,MDA,SOD),neurological function indexes(NSE,S100-β) before and after treatment,and adverse reactions were compared between the two groups.Results After 14 days of treatment,the systolic blood flow velocity,mean blood flow velocity and cerebrovascular reserve function of the two groups were higher than those before treatment,and the pulse index decreased compared with that before treatment,and the increase/decrease range of the combined thrombolysis group were greater than those of the alteplase group(P<0.01);Serum levels of GSH-Px and SOD increased,serum levels of MDA,NSE and S100-β decreased in the two groups,and the increase/decrease range of the combined thrombolysis group were greater than those of the alteplase group(P<0.05 or P<0.01).The total incidence of adverse reactions in the combined thrombolysis group was 15.64%,and there was no statistically significant difference compared with 19.35% in the ateplase group(χ^(2)=0.152,P=0.697).Conclusion Edaravone and dextranol combined with alteplase thrombolytic therapy has a good effect in the treatment of acute cerebral infarction,which is conducive to enhancing blood supply to the brain,alleviating oxidative stress in the body,improving neurological function,with fewer adverse reactions,has high safety.