依达拉奉右崁醇辅助治疗急性脑梗死的临床效果及对脑循环动力学和出血性转化的影响  

Clinical efficacy of edaravone dexkanol in adjuvant treatment of acute cerebral infarction and its influence on cerebral circulation dynamics and hemorrhagic transformation

作　　者：苑瑞敏 解渊[1] 杨文清 李争 徐跃杰 Yuan Rui-min;Xie Yuan;Yang Wen-qing;Li Zheng;Xu Yue-jie(Department of Neurology,the 17th Metallurgical Hospital,Ma'anshan 243000,China)

机构地区：[1]安徽省马鞍山市十七冶医院神经内科,马鞍山243000

出　　处：《中国药物应用与监测》2024年第5期509-513,共5页Chinese Journal of Drug Application and Monitoring

摘　　要：目的分析依达拉奉右莰醇辅助治疗急性脑梗死(ACI)的临床效果及对脑循环动力学、出血性转化(HT)的影响。方法本项目为回顾性研究,研究对象来源于安徽省马鞍山市十七冶医院神经内科收治的110例ACI患者,经随机数字表法分组,每组55例。110例患者中5例被剔除,符合纳入、排除标准的105例患者,其中对照组52例给予常规治疗与丁苯酞氯化钠注射液联合治疗,观察组53例在对照组治疗的基础上加用依达拉奉右崁醇治疗。在治疗前、治疗后对患者脑循环动力学、氧化应激指标、血清生长因子、神经标志物及炎症因子水平进行分析,评估临床疗效和安全性。结果治疗后,两组患者最小血流速度(V_(min))、最小血流量(Q_(min))均升高,且观察组[分别为(10.58±1.13)cm·s^(-1)、(5.38±0.82)mL·s^(-1)]较对照组[分别为(9.63±1.07)cm·s^(-1)、(4.79±0.69)mL·s^(-1)]高,两组脑血管阻力(R)及脉搏波波速(WV)均下降,且观察组[分别为(1736.59±167.58)(Pa·s)·mL^(-1)、(19.07±3.06)m·s^(-1)]较对照组[分别为(1881.64±171.52)(Pa·s)mL^(-1)、(20.89±3.15)m·s^(-1)]低,差异有统计学意义(P<0.05)。治疗后,两组超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、血管内皮生长因子(VEGF)、胰岛素样生长因子1(IGF-1)、脑源性神经营养因子(BDNF)均升高,氧化应激指标(MDA)、中枢神经特异蛋白(S100β)、神经元特异性烯醇化酶(NSE)、视锥蛋白样蛋白1(VILIP-1)、超敏C反应蛋白(hs-CRP)、基质金属蛋白酶9(MMP-9)、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)均下降,差异有统计学意义(P<0.05);观察组SOD、GSH-Px、VEGF、IGF-1、BDNF[分别为(121.62±14.75)U·mL^(-1)、(70.19±5.07)μmol·L^(-1)、(316.27±31.52)pg·mL^(-1)、(161.82±18.65)ng·mL^(-1)、(32.83±3.89)pg·mL^(-1)]较对照组[分别为(106.58±11.67)U·mL^(-1)、(61.34±4.29)μmol·L^(-1)、(291.61±28.73)pg·mL^(-1)、(145.07±15.94)ng·mL^(-1)、(27.26±3.53)pg·mL^(-Objective To observe and analyze the clinical efficacy of edaravone dextroc amphorol in the adjuvant treatment of acute cerebral infarction(ACI)and its influence on cerebral circulation dynamics and hemorrhagic transformation(HT).Methods In this retrospective study,the subjects were 110 patients with ACI admitted to the Department of Neurology,the 17th Metallurgical Hospital of Ma’anshan City.The patients were divided into two groups by random number table method,with 55 in each group.Among the 110 patients,5 patients were excluded and 105 patients met the inclusion and exclusion criteria.Of the 105 patients,52 patients in the control group were given conventional treatment combined with butylphthalein sodium chloride injection,and 53 patients in the observation group were given edaravone dexcanol.The levels of cerebral circulation dynamics,oxidative stress indexes,serum growth factors,nerve markers and inflammatory factors were determined and analyzed before and after treatment to evaluate the clinical efficacy and safety.Results After treatment,the minimum blood flow velocity(Vmin)and minimum blood flow(Qmin)were increased in both groups,which were higher in the observation group((10.58±1.13)cm·s^(-1),(5.38±0.82)mL·s^(-1),respectively)than in the control((9.63±1.07)cm·s^(-1),(4.79±0.69)mL·s^(-1)).The cerebrovascular resistance(R)and pulse wave velocity(WV)decreased in both groups and they were significantly lower in the observation group((1736.59±167.58)(Pa·s)·mL^(-1),(19.07±3.06)m·s^(-1))than in the control((1881.64±171.52)(Pa·s)·mL^(-1),(20.89±3.15)m·s^(-1)),the difference was statistically significant(P<0.05).The superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),vascular endothelial growth factor(VEGF),insulin-like growth factor-1(IGF-1)and brain-derived neurotrophic factor(BDNF)were increased while oxidative stress index(MDA),central nerve specific protein(S100β),neuron-specific enolase(NSE),trypophenin-like protein-1(VILIP-1),hypersensitive C-reactive protein(hs-CRP),matrix meta

关 键 词：急性脑梗死 依达拉奉右崁醇 脑循环动力学 出血性转化 氧化应激 

分 类 号：R743.33[医药卫生—神经病学与精神病学]