EDDE联合依折麦布对高脂血症合并WSI患者血脂、炎症/神经通路及脑细胞凋亡因子的影响  

Effect of edaravone dexborneol combined with ezetimibe on blood lipids,inflammation/neural pathways,and brain cell apoptosis factors in patients with hyperlipidemia and watershed infarction

作　　者：刘博[1] 潘锡正 刘芳[1] 王飞[2] LIU Bo;PAN Xi-zheng;LIU Fang;WANG Fei(Department of Neurology,the Second People's Hospital of Zhengzhou,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州市第二人民医院神经内科,河南郑州450000 [2]郑州市第二人民医院神经外科,河南郑州450000

出　　处：《海南医学》2024年第18期2601-2606,共6页Hainan Medical Journal

基　　金：2022年河南省医学科技攻关联合共建项目(编号:LHGJ20220817)。

摘　　要：目的探究依达拉奉右莰醇(EDDE)联合依折麦布在高脂血症合并分水岭脑梗死(WSI)患者治疗中的潜在机制。方法选取2021年3月至2023年12月郑州市第二人民医院收治的80例高脂血症合并WSI患者纳入研究,按随机数表法分为研究组和对照组各40例,对照组患者在常规治疗的基础上采用依折麦布治疗,研究组在对照组治疗的基础上联合EDDE治疗,连续治疗14 d。治疗后比较两组患者的临床疗效,以及治疗前后的血脂水平[高密度脂蛋白胆固醇(HDL-C)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]、CD40/CD40L炎症信号通路[白介素-1(IL-1)、白介素-6(IL-6)、白介素-10(IL-10)、可溶性CD40配体(sCD40L)]、磷酸肌醇-3-激酶(PI3K)/苏氨酸蛋白激酶(AKT)神经信号通路、脑细胞凋亡因子[抗凋亡因子(Livin)、可溶性凋亡相关因子(sFas)、sFas配体(sFasL)]、功能恢复情况[神经功能缺损(NIHSS)、认知功能(MMSE)]。结果研究组患者的治疗总有效率为92.50%,明显高于对照组的75.00%,差异有统计学意义(P<0.05);治疗14 d后,研究组患者TC、TG、LDL-C明显低于对照组,HDL-C高于对照组,差异均有统计学意义(P<0.05);治疗14 d后,研究组患者IL-1、IL-6、sCD40水平分别为(8.12±1.25)pg/mL、(1.53±0.34)pg/mL、(185.29±45.32)pg/mL,明显低于对照组的(13.78±1.64)pg/mL、(2.55±0.40)pg/mL、(289.18±52.25)pg/mL,IL-10水平为(49.10±4.28)pg/mL,明显高于对照组的(37.75±5.44)pg/mL,差异均有统计学意义(P<0.05);治疗14 d后,研究组患者PMBC内的PI3K、AKT、mTOR蛋白表达分别为1.34±0.23、1.25±0.26、1.57±0.35,明显高于对照组的1.10±0.19、1.11±0.21、1.23±0.24,差异均有统计学意义(P<0.05);治疗14 d后,研究组患者的血清sFasL、sFas水平分别为(2.42±0.41)ng/mL、(3.65±0.47)ng/mL,明显低于对照组的(4.26±0.58)ng/mL、(6.04±0.59)ng/mL,Livin水平为(9.57±1.18)μmol/L,明显高于对照组的(7.42±1.05)μmol/L,差异均有统计学意义Objective To explore the potential mechanism of edaravone dexborneol(EDDE)combined with ezetimibe in the treatment of patients with hyperlipidemia and watershed infarction(WSI).Methods A total of 80 patients with hyperlipidemia and WSI admitted to the Second People's Hospital of Zhengzhou from March 2021 to December 2023 were enrolled and randomly divided into a study group and a control group,with 40 patients in each group.Patients in the control group received ezetimibe treatment on the basis of conventional treatment,while those in the study group received ezetimibe treatment in combination with EDDE treatment on the basis of conventional treatment,for a continuous period of 14 days.After treatment,the clinical efficacy of the two groups of patients was compared,as well as the blood lipid levels(highdensity lipoprotein cholesterol,HDLC;cholesterol,TC;triglycerides,TG;lowdensity lipoprotein cholesterol,LDLC),CD40/CD40L inflammatory signaling pathway(interleukin1,IL1;interleukin6,IL6;interleukin10,IL10;soluble CD40 ligand,sCD40L),phosphoinositide 3kinase(PI3K)/threonine protein kinase(AKT)neural signaling pathway,brain cell apoptosis factors(antiapoptosis factor,Livin;soluble apoptosisrelated factor,sFas;sFas ligand,sFasL),functional recovery(neurological impairment,NIHSS),cognitive function(Minimental State Examination,MMSE)before and after treatment.Results The total effective rate of treatment in the study group was 92.50%,which was significantly higher than 75.00%in the control group(P<0.05).After 14 days of treatment,the TC,TG,and LDLC levels in the study group were significantly lower than those in the control group,while the HDLC level was significantly higher than that in the control group,with statistically significant differences(P<0.05).After 14 days of treatment,the levels of IL1,IL6,and sCD40 in the study group were(8.12±1.25)pg/mL,(1.53±0.34)pg/mL,and(185.29±45.32)pg/mL,respectively,which were lower than(13.78±1.64)pg/mL,(2.55±0.40)pg/mL,and(289.18±52.25)pg/mL in the control group,and the lev

关 键 词：依达拉奉右莰醇 高脂血症 分水岭脑梗死 CD40/CD40L信号通路 PI3K/Akt信号通路 疗效 

分 类 号：R589.2[医药卫生—内分泌]