依达拉奉右莰醇联合丁苯酞对急性脑梗死患者静脉溶栓后神经功能缺损程度及神经元保护作用  

Effect of Edaravone Dexcampol Combined with Butylphthalide on the Degree of Neurological Deficit and Neuronal Protection in Patients with Acute Cerebral Infarction after Intravenous Thrombolysis

作　　者：胡樑臣 李可静 于学会 刘俊明 赵佳 HU Liang-chen;LI Ke-jing;YU Xue-hui;LIU Jun-ming;ZHAO Jia(Department of Emergency,Hebei Petro China Central Hospital,Lang fang 065000,China)

机构地区：[1]河北中石油中心医院急诊科,廊坊065000

出　　处：《微循环学杂志》2023年第1期33-37,共5页Chinese Journal of Microcirculation

基　　金：廊坊市科学技术研究与发展计划项目(2021013039)。

摘　　要：目的:评价依达拉奉右莰醇联合丁苯酞对急性脑梗死(ACI)患者静脉溶栓后神经功能缺损程度及神经元的保护作用。方法:选取2020-08-2021-12河北中石油中心医院收治的100例ACI患者,按照随机数字法分为对照组(50例)和观察组(50例),对照组采用重组人组织型纤溶酶原激活物(rt-PA)溶栓治疗,观察组在rt-PA溶栓基础上给予依达拉奉右莰醇联合丁苯酞治疗。比较两组治疗7天后美国国立卫生研究院脑卒中量表(NIHSS)评分下降≥4分率、治疗90天改良Rankin量表(mRS)评分≤2分率、治疗过程中出血性转化率及不良反应发生率。比较两组治疗前后同型半胱氨酸(Hcy)、神经元特异性烯醇化酶(NSE)、NIHSS评分和mRS评分的变化。结果:观察组治疗7天后NIHSS评分下降≥4分的发生率和治疗90天后mRS评分≤2分的发生率分别为86.00%和78.00%,高于对照组的68.00%和56.00%,差异均有统计学意义(P<0.05)。治疗前,两组NIHSS评分、mRS评分、血清Hcy、NSE差异无统计学意义(P>0.05),两组治疗后7天、90天NIHSS评分、mRS评分下降(P<0.01),血清Hcy、NSE水平降低,且观察组较对照组下降更明显(P<0.01)。观察组出血性转化率和不良反应发生率分别为6.00%和18.00%,与对照组的12.00%和12.00%比较,差异无统计学意义(P>0.05)。结论:ACI患者rt-PA溶栓术后,应用依达拉奉右莰醇联合丁苯酞治疗可减轻患者神经功能损害,降低Hcy、NSE水平,且安全性高,值得临床推广应用。Objective: To evaluate effect of edaravone dexcamphor combined with butylphthalide on the degree of neurological deficit and neuron protection in patients with acute cerebral infarction(ACI) after intravenous thrombolysis. Method: A total of 100 ACI patients from August 2020 to December 2021 were selected as the research objects and divided into the control group(50 cases) and the observation group(50 cases) according to the random number method. The control group was treated with recombinant human tissue plasminogen activator(rt-PA) thrombolytic therapy, and the observation group was treated withthe basis of rt-PA thrombolysis, edaravone dexbornol combined with butylphthalide was given. The national institutes of health stroke scale(NIHSS) score decline rate of ≥4 points, the modified rankin scale(mRS) score of ≤2 points at 90 days, the rate of hemorrhagic transformation during treatment and the rate of adverse reactions were compared between the two groups. The differences in homocysteine(Hcy) and neuron-specific enolase(NSE) between the two groups were detected, and the changes in the NIHSS and mRS scores of the two groups were evaluated.Results:The incidence of NIHSS score drop ≥ 4points after 7days of treatment in the observation group and the incidence of mRS score≤2points on 90days were86.00% and 78.00%,respectively,which were higher than 68.00%and 56.00%of the control group.The difference was statistically significant.(P<0.05).Before treatment,there was no significant difference in NIHSS score,mRS score,Hcy and NSE between two groups(P>0.05).Compared with before treatment,NIHSS score,mRS score,Hcy and NSE were decreased at 7and 90days of treatment in the two groups,the decrease in the observation group was more obvious than that in the control group(P<0.01).The hemorrhagic conversion rate and the adverse reaction rate of the observation group were 6.00%and 18.00%,respectively.Compared with the 12.00%and 12.00% of the control group,the difference was not statistically significant(P>0.05).Conclusion

关 键 词：依达拉奉右莰醇 丁苯酞 重组人组织型纤溶酶原激活物 急性脑梗死 

分 类 号：R743[医药卫生—神经病学与精神病学]