依达拉奉右莰醇联合rt-PA治疗急性脑梗死的疗效  

Influence of edaravone dexborneol combined with rt-PA on levels of peripheral blood CysC and RBP in treating acute cerebral infarction

作　　者：罗明晶 刘婧 王心怡[2] 徐凤[3] 彭松[4] LUO Mingjing;LIU Jing;WANG Xinyi;XU Feng;PENG Song(Western District Rehabilitation Department,Hefei First People's Hospital,Hefei 230088,China;Department of Radiology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Emergency Internal Medicine,The Second Hospital of Anhui Medical University,Hefei 230601,China;Western District General Medicine Department,Hefei First People's Hospital,Hefei 230088,China)

机构地区：[1]合肥市第一人民医院西区康复科,安徽合肥230088 [2]安徽医科大学第一附属医院放射科,安徽合肥230022 [3]安徽医科大学第二附属医院急诊内科,安徽合肥230601 [4]合肥市第一人民医院西区全科医学科,安徽合肥230088

出　　处：《西部医学》2025年第2期284-288,294,共6页Medical Journal of West China

基　　金：2021年安徽省健康发展战略研究中心招标咨政项目(2021szk013)。

摘　　要：目的 探讨依达拉奉右莰醇联合重组组织型纤溶酶原激活物(rt-PA)治疗急性脑梗死(ACI)的疗效及对患者外周血胱抑素C(CysC)、视黄醇结合蛋白(RBP)水平的影响。方法 选取2019年6月—2023年6月合肥市第一人民医院收治的110例ACI患者为研究对象,随机分为观察组和对照组,每组55例。对照组给予常规治疗及rt-PA治疗,观察组给予常规治疗及依达拉奉右莰醇联合rt-PA治疗。比较两组患者治疗前及治疗7 d后的神经功能[美国国立卫生研究院卒中量表(NIHSS)]、认知功能[精神状态检查表(MMSE)]、日常活动能力[Barthel指数评定量表(MBI)]、脑血流动力学指标[双侧颈内动脉收缩期峰值血液流速(Vs)、舒张期血液流速(Vd)、平均流速(Vm)]、外周血氧化应激水平[超氧化物歧化酶(SOD)、活性氧(ROS)、丙二醛(MDA)]、炎症指标[C反应蛋白(CRP)、血清基质金属蛋白酶-9(MMP-9)、血清基质金属MMP-12]及外周血CysC、RBP水平变化情况。结果 治疗后,两组NIHSS评分和外周血MDA、ROS、CRP、MMP-9、MMP-12、CysC水平均低于治疗前,且观察组低于同一时期对照组(P<0.05);两组MMSE评分、MBI评分、外周血SOD、RBP水平和双侧颈内动脉Vs、Vd、Vm速度均高于治疗前,且观察组高于同一时期对照组(P<0.05)。结论 采用依达拉奉右莰醇联合rt-PA治疗ACI疗效良好,可改善患者神经功能、认知功能和日常活动能力,加快双侧颈内动脉血流速度,减轻氧化应激反应及炎症反应,纠正外周血CysC、RBP水平,有利于促进患者预后康复。Objective To explore the efficacy of edaravone dexborneol combined with recombinant tissue plasminogen activator(rt-PA) in the treatment of acute cerebral infarction(ACI) and the influence on peripheral blood cystatin C(CysC) and retinol-binding protein(RBP) levels of patients.Methods 110 patients with ACI admitted from June 2019 to June 2023 in Hefei First People' s Hospital were selected as the study subjects,and were randomly divided into study group(55 cases) and control group(55 cases) by coin tossing method.The control group was treated with rt-PA,and the study group was given edaravone dexborneol combined with rt-PA.The neurological function [National Institutes of Health Stroke Scale(NIHSS)],cognitive function [Mini-Mental State Examination(MMSE)],daily activity ability [Modified Barthel Index(MBI)],cerebral hemodynamic indicators [bilateral internal carotid artery peak systolic blood flow velocity(Vs),diastolic blood flow velocity(Vd),mean blood flow velocity(Vm)],peripheral blood oxidative stress [superoxide dismutase(SOD),reactive oxygen species(ROS),malondialdehyde(MDA)],inflammatory indicators [C-reactive protein(CRP),serum matrix metalloproteinase-9(MMP-9),serum matrix metalloproteinase-12(MMP-12)],peripheral blood CysC and RBP of the two groups were compared before treatment and after 7 days of treatment.Results After treatment,the NIHSS score,peripheral blood MDA,ROS,CRP,MMP-9,MMP-12 and CysC in both groups were lower than those before treatment,and the above indicators in study group were lower than those in control group during the same period(P<0.05).The MMSE score,MBI score,peripheral blood SOD and RBP and bilateral internal carotid artery Vs,Vd and Vm were higher in both groups than those before treatment,and the indicators were higher in study group compared with those in control group(P<0.05).Conclusion Edaravone dexborneol combined with rt-PA has good efficacy,and it can improve the neurological function,cognitive function and daily activity ability,accelerate the bilateral internal caroti

关 键 词：依达拉奉右莰醇 重组组织型纤溶酶原激活剂 急性脑梗死 双侧颈内动脉血流速度 炎症反应 外周血胱抑素C 外周血视黄醇结合蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]