依达拉奉右莰醇联合rt-PA静脉溶栓治疗急性缺血性卒中的疗效观察

The efficacy of edaravone dexborneol combined with rt-PA intravenous thrombolysis for acute ischemic stroke

目的观察依达拉奉右莰醇联合重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓(IVT)治疗急性缺血性卒中(AIS)的疗效。方法回顾性选取2021年11月至2022年12月在绍兴市人民医院接受rt-PA IVT治疗的100例AIS患者为研究对象,采用依达拉奉右莰醇联合rt-PA IVT治疗50例,为观察组;采用依达拉奉联合rt-PA IVT治疗50例,为对照组。观察并比较两组患者临床疗效、不良反应以及治疗前后神经功能[采用美国国立卫生卒中评分量表(NIHSS)评估]、预后状况[采用改良Rankin量表(m RS)评估]、血清炎症因子[包括肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)]水平变化。结果观察组治疗总有效率(96.0%比82.0%)、90 d预后良好率(74.0%比54.0%)均明显高于对照组(均P<0.05)。治疗后14、90 d两组患者NIHSS、m RS评分均较治疗前明显降低(均P<0.05),且治疗后90 d均明显低于治疗后14 d(均P<0.05);观察组治疗后14、90 d NIHSS、m RS评分均明显低于对照组(均P<0.05)。治疗后7 d两组患者血清TNF-α及观察组IL-1β水平均较治疗前明显降低(均P<0.05),且观察组均明显低于对照组(均P<0.01)。两组患者不良反应发生率比较差异无统计学意义(P=0.126)。结论依达拉奉右莰醇联合rt-PA IVT能有效改善AIS患者神经功能和预后,且不增加不良反应。

Objective To observe the effect of intravenous thrombolysis(IVT)with edaravone dexborneol combined with recombinant tissue plasminogen activator(rt-PA)on acute ischemic stroke(AIS).Methods One hundred AIS patients who received rt-PA IVT treatment in Shaoxing People's Hospital from November 2021 to December 2022 were included.Among them,50 cases each received treatment of edaravone dexborneol combined with rt-PA IVT(observation group)and edaravone combined with rt-PA IVT(control group),respectively.The clinical efficacy,adverse reactions,and the changes of neurological function[assessed by National Institute of Health Stroke Scale(NIHSS)],the prognosis[assessed by modified Rankin Scale(mRS)],and serum inflammatory factors[including tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)]were observed and compared between the two groups.Result The effective rate(96.0%vs.82.0%)and 90-day good outcome rate(74.0%vs.54.0%)in the observation group were significantly higher than those in the control group(all P<0.05).NIHSS and mRS Scores in both groups were significantly lower at 14 and 90 days after treatment than before treatment(all P<0.05),and were significantly lower at 90 days than at 14 days after treatment(all P<0.05).NIHSS and mRS Scores were significantly lower in the observation group than in the control group at 14 and 90 days after treatment(all P<0.05).After 7 days treatment,serum TNF-琢in both groups and IL-1茁in the observation group were significantly decreased than before the treatment(all P<0.05),and were significantly lower in the observation group than in the control group(all P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.126).Conclusion Edaravone dexborneol combined with rt-PA IVT can effectively improve the neurological function and prognosis of AIS patients without increasing adverse reactions.