依达拉奉右莰醇治疗血管介入术后急性脑梗死的疗效及对血液流变学和血清Lp-PLA2 NSE水平的影响  

Effect of edaravone-dexborneol in the treatment of acute cerebral infarction after vascular intervention surgery and its impact on hemorheology,serum Lp-PLA2 and NSE levels

作　　者：王晓辉[1] 蒋锋[1] 常莎 李志伟[1] 王乐[1] WANG Xiaohui;JIANG Feng;CHANG Sha;LI Zhiwei;WANG Le(Shaanxi Provincial People’sHospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院,陕西西安710068

出　　处：《中国实用神经疾病杂志》2024年第9期1057-1061,共5页Chinese Journal of Practical Nervous Diseases

基　　金：陕西省自然科学基金面上项目(编号:2022JM-594)。

摘　　要：目的探讨依达拉奉右莰醇治疗血管介入术后急性脑梗死患者(ACI)的临床效果,以及血液流变学和血清脂蛋白相关磷脂酶A2(Lp-PLA2)、神经元特异性烯醇化酶(NSE)水平的影响。方法选入2020-01—2023-01在陕西省人民医院行血管介入术治疗的ACI患者120例,根据术后治疗方案不同分为2组,各60例。对照组接受常规治疗,观察组接受常规治疗+依达拉奉右莰醇治疗。评价2组的临床疗效、血液流变学、血清Lp-PLA2和NSE水平变化等,并进行比较。结果2组术后各观测点(术后7d、14d和6个月)采用美国国立卫生研究院卒中量表(NIHSS)评分均较术前降低(P<0.05),且观察组更低(P<0.05);观察组治疗总有效率为93.33%,高于对照组的75.00%(P<0.05);2组术前血液流变学指标无统计学差异(P>0.05),术后14 d观察组血浆黏度(PV)、全血高切黏度(HSV)与低切黏度(LSV)均低于对照组(P<0.05);相较于术前,2组术后14 d血清Lp-PLA2和NSE水平降低(P<0.05),且观察组更低(P<0.05);2组不良反应总发生率无统计学差异(P>0.05);治疗6个月内,观察组不良结局总发生率为3.33%低于对照组的18.33%(P<0.05)。结论依达拉奉右莰醇可明显提高ACI患者血管介入手术疗效,改善神经功能和血液流变学,调节血清Lp-PLA2、NSE水平,减少不良结局。Objective To investigate the clinical effect of edaravone-dexcamphorol in the treatment of ACI after vascular intervention,and the effect on the hemorheology and serum Lp-PLA2 and NSE levels.Methods Totally 120 ACI patients received vascular intervention surgery in Shanxi Prouincial People’s Hospital from January 2020 to January 2023 were selected and divided into the matched group and the combination group based on different postoperative treatment plans,with 60 patients in each group.The matched group received routine treatment,while the combination group received edaravone-dexborneol in addition to the matched group.The clinical efficacy,hemorheology,changes in serum Lp-PLA2 and NSE levels between the two groups were evaluated and compared.Results The score of NIHSS at all observation points(7 days,14 days and 6 months after surgery)in the two groups was lower than before surgery(P<0.05),and the combination group were lower(P<0.05).The total effective rate of combination group was 93.33%,which was higher than 75.00%of matched group(P<0.05).There was no significant difference in hemorheology indexes between the two groups before surgery(P>0.05),but PV,whole blood HSV and LSV at 14 days after surgery in the combination group were lower than matched group(P<0.05).Serum Lp-PLA2 and NSE levels at 14 days after surgery in the two groups decreased(P<0.05),and those in combination group were lower(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After 6 months of treatment,the overall incidence of adverse outcomes in the combination group was 3.33%,which was lower than 18.33%in the matched group(P<0.05).Conclusion The application of edaravone-dexborneol after vascular intervention can significantly improve the therapeutic effect of ACI,improve patients’neurological function and hemorheology,regulate serum Lp-PLA2 and NSE levels,and reduce adverse outcomes.

关 键 词：急性脑梗死 血管介入术 依达拉奉右莰醇 血液流变学 脂蛋白相关磷脂酶 神经元特异性烯醇化酶 血清 

分 类 号：R743.33[医药卫生—神经病学与精神病学]