丁苯酞联合依达拉奉右莰醇治疗小动脉闭塞型脑卒中的疗效研究

Efficacy of butylphthalein combined with Edaravone dextrocamphorol in the treatment of arteriolar occlusion type stroke

目的探讨丁苯酞联合依达拉奉右莰醇治疗小动脉闭塞型(SAO)脑卒中的疗效及对血清血管内皮生长因子(VEGF)、miR⁃34a、缺氧诱导因子⁃1α(HIF⁃1α)的影响。方法选取2023年3月至2024年3月在界首市人民医院确诊并接受相关治疗102例SAO脑卒中患者,根据随机数表法分为丁苯酞组(n=51,丁苯酞治疗)和联合组(n=51,丁苯酞联合依达拉奉右莰醇治疗)。比较两组脑血流动力学、神经功能、血清VEGF、miR⁃34a、HIF⁃1α水平及不良反应。结果治疗后联合组相对脑血流量(rCBF)、平均血流量(Qm)、平均血流速度(Vm)高于治疗前及丁苯酞组,差异有统计学意义(t=5.038、3.297、3.308、3.608,P<0.05);治疗后联合组斯堪的那维亚脑卒中量表(SSS)评分高于治疗前及丁苯酞组,神经胶质原纤维酸性蛋白(GFAP)水平低于治疗前及丁苯酞组,差异有统计学意义(t=3.891、4.654、6.339,P<0.05);治疗后联合组外周血HIF⁃1α及miR⁃34a表达量低于治疗前及丁苯酞组,VEGF表达量高于治疗前及丁苯酞组,差异有统计学意义(t=6.436、5.591、4.217,P<0.05);联合组与丁苯酞组药物不良反应比较无统计学差异(χ^(2)=0.270,P>0.05)。结论丁苯酞联合依达拉奉右莰醇治疗SAO脑卒中可以改善患者脑血流动力学及脑组织血流灌注,改善患者神经功能,降低HIF⁃1α、miR⁃34a表达,提高VEGF水平。

Objective To investigate the efficacy of butaphthalein combined with eEdaravone dextrocamphorol in the treatment of small artery occlusion⁃type(SAO)stroke and the effects on serum vascular endothelial growth factor(VEGF),miR⁃34a and hypoxia⁃inducing factor⁃1α(HIF⁃1α).Methods A total of 102 SAO stroke patients diagnosed and treated at Jieshou People's Hospital from March 2023 to March 2024 were selected for the study.They were randomly divided into two groups:the butylphthalein group(n=51,treated with butylphthalein)and the combination group(n=51,treated with butylphthalein treatment and Edaravone dexcarnol)using a random number table method.Cerebral hemodynamics,neurological function,serum miR⁃34a,VEGF,HIF⁃1αlevels and adverse reactions were compared between the two groups.Results After treatment,the relative cerebral blood flow(rCBF),mean blood flow(Qm)and mean blood flow velocity(Vm)of the combination group were statistically higher than those before treatment and the butylphthalein group(t=5.038,3.297,3.308,3.608,P<0.05).After treatment,the Scandinavian Stroke Scale(SSS)score of the combination group was statistically higher than the SSS score of the butylphthalein group,and the levels of glial fibrillary acidic protein(GFAP)in the combination group were statistically lower than those before treatment and in the butylphthalein group(t=3.891,4.654,6.339,P<0.05).After treatment,the expression of HIF⁃1αand miR⁃34a in the peripheral blood of the combination group was statistically lower than before treatment and in the butylphthalein group,and the expression of VEGF was statistically higher than in the butylphthalein group and before treatment(t=6.436,5.591,4.217,P<0.05).There was no significant difference in adverse drug reactions between the two groups(χ^(2)=0.270,P>0.05).Conclusion The combination of buphthalein and Edaravone dextrocamphorol in the treatment of SAO stroke can improve cerebral hemodynamics and cerebral perfusion,enhance neurological function,reduce HIF⁃1αand miR⁃34a expression,and elevate VEGF levels.