复方曲肽注射液联合依达拉奉治疗老年急性脑梗死的疗效评价及其机制研究  

Efficacy evaluation and mechanism study of compound troxerutin and poreine cerebroside injection combined with edaravone in the treatment of elderly patients with acute cerebral infarction

作　　者：崔玉环[1] 杜丹 蒋静 刘玮 刘占矿[1] 颜娟[3] 董利平[1] Cui Yuhuan;Du Dan;Jiang Jing;Liu Wei;Liu Zhankuang;Yan Juan;Dong Liping(Department of Geriatrics,the First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China;Clinical Laboratory,the First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China;Department of Pharmacy,the First Affiliated Hospital of Hebei North University,Hebei,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院老年科,河北张家口075000 [2]河北北方学院附属第一医院检验科,河北张家口075000 [3]河北北方学院附属第一医院药学部,河北张家口075000

出　　处：《中国医学前沿杂志（电子版）》2021年第10期144-149,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2020年度河北省卫健委医学科学研究课题计划(20200560);2018年张家口市科学技术和地震局项目(1821042D)。

摘　　要：目的探究复方曲肽注射液联合依达拉奉治疗老年急性脑梗死的临床疗效及其作用机制。方法选取2019年3月至2020年8月于河北北方学院附属第一医院治疗的老年急性脑梗死患者125例,研究中脱落5例,最终纳入统计的患者共120例,依据随机数字表法将入选患者分为治疗组和对照组,每组各60例。两组患者均接受抗血小板、控制血压、营养支持、改善微循环等常规治疗,在此基础上,治疗组患者给予复方曲肽注射液联合依达拉奉治疗,对照组患者仅给予依达拉奉治疗,均持续治疗14 d。观察两组患者临床疗效和不良反应发生情况,比较两组患者治疗前后美国国家卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、改良Rankin量表(modified Rankin scale,mRS)评分、内皮损伤指标[可溶性血栓调节蛋白(soluble thrombomodulin,sTM)、D-二聚体(D-dimer,D-D)、内皮素1(endothelin 1,ET-1)、可溶性髓样细胞触发受体样转录因子-1(soluble triggering receptor expressed on myeloid cells-like transcript 1,sTLT-1)]、Kelch样环氧氯丙烷相关蛋白-1(Kelch-like epichlorohydrin-associated protein 1,Keap1)-核转录因子红系2相关因子2(nuclear factor-erythroid 2-related factor 2,Nrf2)-抗氧化响应元件(antioxidant response element,ARE)信号通路相关蛋白[血红素加氧酶1(heme oxygenase-1,HO1)、醌氧化还原酶(quinone oxidoreductase 1,NQO1)、Keap1、Nrf2、ARE]水平的差异。结果治疗后两组患者sTM、D-D、ET-1、sTLT-1、Keap1水平和NIHSS、mRS评分均显著低于本组治疗前(均P<0.05),HO1、NQO1、Nrf2、ARE水平均显著高于本组治疗前(均P<0.05),且治疗组患者sTM、D-D、ET-1、sTLT-1、Keap1水平和NIHSS、mRS评分均显著低于对照组(均P<0.05),HO1、NQO1、Nrf2、ARE水平均显著高于对照组(均P<0.05);治疗组患者总有效率显著高于对照组(χ2=6.171,P=0.013);随访期间,两组患者不良反应发生率比较差异无统计学意义(P>0.05)。�Objective To explore the clinical efficacy and possible mechanism of compound troxerutin and poreine cerebroside injection combined with edaravone in the treatment of elderly patients with acute cerebral infarction(ACI).Method A total of 125 elderly patients with ACI who were treated in the First Affiliated Hospital of Hebei North University from March 2019 to August 2020 were selected,and 5 cases were dropped from the study.A total of 120 cases were finally included in the statistics.According to the random number table method,patients were divided into treatment group and control group,with 60 cases in each group.Both groups received conventional treatment such as antiplatelet,blood pressure control,nutritional support,and microcirculation improvement.On this basis,treatment group was treated with compound troxerutin and poreine cerebroside injection combined with edaravone,and control group was treated with edaravone only.All subjects continued treatment for 14 days.The clinical efficacy and adverse reactions of the two groups were observed,and National Institute of Health stroke scale(NIHSS),modified Rankin scale(mRS)score,endothelial injury index[soluble thrombomodulin(sTM),D-dimer(D-D),endothelin 1(ET-1),soluble triggering receptor expressed on myeloid cells-like transcript 1(sTLT-1)],Kelch-like epichlorohydrin-associated protein 1(Keap1)-nuclear factor-erythroid 2-related factor 2(Nrf2)-antioxidant response element(ARE)signaling pathway related protein levels[heme oxygenase-1(HO1),quinone oxidoreductase 1(NQO1),Keap1,Nrf2,ARE]were compared between the two groups.Result After treatment,the levels of sTM,D-D,ET-1,sTLT-1,Keap1 and scores of NIHSS and mRS in two groups were significantly lower than those before treatment(all P<0.05),while the levels of HO1,NQO1,Nrf2 and ARE were significantly higher than those before treatment(all P<0.05).The levels of sTM,D-D,ET-1,sTLT-1,Keap1 and scores of NIHSS and mRS in treatment group were significantly lower than those in control group(all P<0.05),the levels of HO1,NQO1

关 键 词：复方曲肽注射液 依达拉奉 急性脑梗死 老年患者 临床疗效 作用机制 

分 类 号：R743.33[医药卫生—神经病学与精神病学]