依达拉奉右莰醇对老年急性缺血性脑卒中患者外周血氧化应激通路的影响  

Effect of Edaravone and dexborneol on oxidative stress pathway in peripheral blood of elderly patients with acute ischemic stroke

作　　者：马香莲[1] 曾国熙[1] 魏艳娜 杨艺 周文 蒋雪野 赵秀丽[1] 孙娟 Ma Xianglian;Zeng Guoxi;Wei Yanna;Yang Yi;Zhou Wen;Jiang Xueye;Zhao Xiuli;Sun Juan(Department of Neurology,Qinghai University Affiliated Hospital,Xining 810001,China)

机构地区：[1]青海大学附属医院神经内科,西宁810001

出　　处：《中华老年医学杂志》2023年第3期291-296,共6页Chinese Journal of Geriatrics

基　　金：中国卒中学会脑血管病全程管理启航基金(2020017)。

摘　　要：目的 探讨依达拉奉右莰醇注射用浓溶液对老年急性缺血性脑卒中患者外周血氧化应激通路的影响。方法 前瞻性选取青海大学附属医院神经内科2021年7月至2022年1月老年急性缺血性脑卒中患者87例作为研究对象,按随机数字表法分为对照组(44例)和依达拉奉右莰醇组(43例),各组按照发病时间分为<12 h组、12~24 h组、24~48 h组,分别采集入院及出院时患者外周血,检测血清中活性氧(ROS)、Kelch样环氧氯丙烷相关蛋白1(Keap1)、核因子-E2相关因子2(Nrf2)、血红素加氧酶-1(HO-1)、NAD(P)H醌氧化还原酶1(NQO1)、肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)浓度及超氧化物歧化酶(SOD)活力、丙二醛(MDA)含量。结果 老年急性缺血性脑卒中患者入院后给予依达拉奉右莰醇治疗,能降低患者血清中ROS、TNF-α、IL-6浓度及MDA含量,升高Keap1、Nrf2、HO-1、NQO1浓度及SOD活力,除<12 h组ROS浓度、<12 h及12~24 h组SOD活力外,其余组差异均具有统计学意义(均P<0.05);出院时给予依达拉奉右莰醇组与对照组比较,患者血清中TNF-α、IL-6浓度下降,Nrf2浓度(24~48 h组)、HO-1浓度(24~48 h组)、SOD活力上升,差异均具有统计学意义(均P<0.05);对照组出院时与入院时比较,ROS浓度(24~48 h组)、MDA含量、TNF-α浓度(<12 h、24~48 h组)、IL-6浓度下降,Keap1、Nrf2(<12 h、12~24 h组)、HO-1(<12 h、12~24 h组)浓度上升,差异均具有统计学意义(均P<0.05);依达拉奉右莰醇组出院时与入院时比较,Keap1浓度(24~48 h组)、HO-1浓度(24~48 h组)、SOD活力(<12 h、12~24 h组)上升,MDA含量(12~24 h组)下降,差异均具有统计学意义(均P<0.05)。结论 依达拉奉右莰醇能通过对Keap1/Nrf2通路的影响减轻老年急性缺血性脑卒中患者外周血中氧化应激及炎症反应。Objective To investigate the effect of Edaravone and dexborneol(Eda.B)on oxidative stress pathway in peripheral blood of elderly patients with acute ischemic stroke.Methods A total of 87 elderly patients with acute ischemic stroke in the Department of Neurology,Qinghai University Affiliated Hospital from July 2021 to January 2022 were selected as the study subjects.According to the random number table,they were divided into control group(44 cases)and edaravone dexborneol group(43 cases).Each group was divided into<12 h group,12-24 h group and 24-48 h group according to the time of onset.Peripheral blood was collected in each group at admission and discharge,respectively.The serum levels of reactive oxygen species(ROS),Kelch-like epichlorohydrin-associated protein 1(Keap1),nuclear factor-E2-associated factor 2(Nrf2),heme oxygenase-1(HO-1),NAD(P)H quinone oxidoreductase 1(NQO1),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),as well as superoxide dismutase(SOD)activity and malondialdehyde(MDA)content were detected.Results Elderly patients with acute ischemic stroke receving Eda.B treatment after admission could reduce the serum concentration of ROS,TNF-αand IL-6,as well as MDA content,and increase the concentration of Keap1,Nrf2,HO-1 and NQO1 and SOD activity.Except for ROS concentration in<12 h group and SOD activity in<12 h and 12 h-24 h groups,the differences between the other groups were statistically significant(P<0.05 for all).Compared with the control group,the serum concentration of TNF-αand IL-6 of patients in the Eda.B group at discharge decreased,while the concentration of Nrf2(24-48 h group)and HO-1(24-48 h group),and SOD activity increased,the differences were statistically significant(P<0.05 for all).In the control group at discharge,the concentrations of ROS(24-48 h group),TNF-α(<12 h group,24-48 h group)and IL-6,as well as MDA content decreased,while the concentrations of Keap1,Nrf2(<12 h group,12-24 h group)and HO-1(<12 h group,12-24 h group)increased,the differences were also statistica

关 键 词：卒中 缺氧缺血 脑 氧化性应激 炎症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]