依达拉奉右莰醇联合rt-PA静脉溶栓治疗超早期急性脑梗死的疗效及对预后的影响  

Effects of edaravone dexborneol combined with rt-PA intravenous thrombolysis therapy on efficacy and prognosis of ultra-early acute cerebral infarction

作　　者：聂亚蒙 张小强 冯鹏展 丁雅倩 NIE Yameng;ZHANG Xiaoqiang;FENG Pengzhan;DING Yaqian(Department of Neurology,Mengcheng NO.1 People's Hospital,Bozhou 233500,China)

机构地区：[1]安徽省蒙城县第一人民医院神经内科,233500

出　　处：《天津医药》2023年第7期766-771,共6页Tianjin Medical Journal

摘　　要：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)静脉溶栓治疗超早期急性脑梗死(ACI)的疗效及对预后的影响。方法选取163例超早期ACI患者,采用投掷法分为联合用药组(依达拉奉右莰醇联合rt-PA静脉溶栓治疗)78例和对照组(rt-PA静脉溶栓治疗)85例。观察2组疗效,治疗前后超氧化物歧化酶(SOD)、活性氧簇(ROS)、丙二醛(MDA)、神经元特异性烯醇化酶(NSE)、基质金属蛋白酶(MMP)-9、MMP-12、中枢神经特异性蛋白β(S100β)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、D-二聚体(D-D)、C反应蛋白(CRP)水平和美国国立卫生院卒中量表(NIHSS)、改良Rankin量表(mRS)、日常生活活动能力(ADL)评分变化;比较2组病死率和不良反应发生率。结果联合用药组总有效率、SOD水平和ADL评分高于对照组,ROS、MDA、NSE、MMP-9、MMP-12、S100β蛋白水平及NIHSS、mRS评分低于对照组(P<0.05);2组治疗后3个月内病死率和不良反应发生率比较差异无统计学意义(P>0.05)。结论依达拉奉右莰醇联合rt-PA静脉溶栓治疗超早期ACI可提高患者临床疗效,并有效改善患者预后。Objective To observe the efficacy and prognosis of edaravone dexborneol combined with intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA)in the treatment of ultra-early acute cerebral infarction(ACI).Methods A total of 163 patients with ultra-early ACI were randomly divided into the combination group(treated with edaravone dexborneol combined with intravenous thrombolysis with rt-PA,n=78)and the control group(treated with intravenous thrombolysis with rt-PA,n=85).Therapeutic effects and changes of superoxide dismutase(SOD),reactive oxygen species(ROS),malondialdehyde(MDA),neuron-specific enolase(NSE),matrix metalloproteinase-9(MMP-9),matrix metalloproteinase-12(MMP-12),central nervous system-specific proteinβ(S100β),low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),D-dimer(D-D),C-reactive protein(CRP),the National Institutes of Health Stroke Scale(NIHSS)scores,Modified Rankin Scale(mRS)scores and activity of daily living(ADL)scores were observed before and after treatment in the 2 groups.The fatality rate and the incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate,SOD level and ADL score were higher in the combination group than those in the control group.Levels of ROS,MDA,NSE,MMP-9 and S100β,NIHSS score and mRS score were lower in the combination group than those in the control group(P<0.05).There were no significant differences in fatality rate and incidence of adverse reactions between the two groups(P>0.05).Conclusion Edaravone dexborneol combined with intravenous thrombolysis with rt-PA can improve the clinical effect in the treatment of patients with ultra-early ACI,and improve the prognosis.

关 键 词：脑梗死 药物疗法 联合 预后 依达拉奉右莰醇 重组组织型纤溶酶原激活剂 

分 类 号：R743.33[医药卫生—神经病学与精神病学]