依达拉奉右莰醇联合替罗非班对急性脑梗死患者脑血流动力学及氧化应激的影响

黄良通; 徐灵燕

doi:10.16766/j.cnki.issn.1674-4152.003058

依达拉奉右莰醇联合替罗非班对急性脑梗死患者脑血流动力学及氧化应激的影响

doi: 10.16766/j.cnki.issn.1674-4152.003058

黄良通^,,
徐灵燕

温州医科大学附属第五医院(丽水市中心医院)神经内科，浙江丽水 323000

基金项目:

浙江省医药卫生科技计划项目 2022ZH079

详细信息

通讯作者:
黄良通，E-mail：huangliangtong_hlt@163.com

中图分类号: R743.3
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出版历程
- 收稿日期: 2023-04-06
- 网络出版日期: 2023-08-28

Effects of edaravone dexborneol combined with tirofiban on cerebral hemodynamics and oxidative stress in patients with acute cerebral infarction

HUANG Liangtong^,,
XU Lingyan

Department of Neurology, the Fifth Affiliated Hospital of Wenzhou Medical University (Lishui Central Hospital), Lishui, Zhejiang 323000, China

摘要

摘要: 目的近年来急性脑梗死发病率逐年升高，为寻找更多治疗急性脑梗死的有效方法，本研究将依达拉奉右莰醇联合替罗非班应用于急性脑梗死患者的治疗中，探究其对脑血流动力学及氧化应激的影响。方法纳入2021年1月—2022年12月在丽水市中心医院就诊的220例急性脑梗死患者作为研究对象，并根据治疗方法分为A组(108例)和B组(112例)。A组给予替罗非班及常规治疗，B组在A组的基础上给予依达拉奉右莰醇治疗。比较2组临床疗效、不良反应和治疗前后脑血流动力学、氧化应激及血清炎性因子指标。结果治疗后，2组患者美国国立卫生研究院卒中量表评分明显低于治疗前，且B组明显低于A组[(3.44±0.53)分vs. (3.67±0.77)分，t=2.589, P=0.010]。治疗后，2组患者阻力指数、丙二醛、去甲肾上腺素、肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平明显低于治疗前，且B组明显低于A组(均P＜0.05)；2组患者最大血流速度、平均血流速度、超氧化物歧化酶水平明显高于治疗前，且B组明显高于A组(均P < 0.05)。2组患者牙龈出血、胃肠道反应、头晕头痛、颅内出血发生情况比较差异无统计学意义(P>0.05)。结论依达拉奉右莰醇联合替罗非班在急性脑梗死患者中疗效较佳，具有改善脑血流动力学、氧化应激、炎症反应的作用，且对不良反应无明显影响。
- 依达拉奉右莰醇 /
- 替罗非班 /
- 急性脑梗死 /
- 脑血流动力学 /
- 氧化应激
Abstract: Objective In recent years, the incidence of acute cerebral infarction has been increased year by year. In order to find more effective methods for the treatment of acute cerebral infarction, this study used edaravone dexborneol combined with tirofiban in the treatment of patients with acute cerebral infarction, to investigate its effect on cerebral hemodynamics and oxidative stress. Methods A total of 220 patients with acute cerebral infarction who admitted to Lishui Central Hospital from January 2021 to March 2022 were selected as research objects, and they were divided into group A (n=108) and group B (n=112) by therapeutic method. Group A was treated with tirofiban, i.e. conventional treatment, and group B was treated with edaravone dexborneol on the basis of the group A. The clinical efficacy, adverse effects, cerebral hemodynamics, oxidative stress and serum inflammatory factors were compared between the two groups. Results After treatment, the national institutes of health stroke scale (NIHSS) of the two groups was significantly lower than that before treatment, and the NIHSS of group B was significantly lower than that of group A [(3.44±0.53) points vs. (3.67±0.77) points, t=2.589, P=0.010]. After treatment, the levels of resistance index, malondialdehyde, norepinephrine, tumor necrosis factor-α, interleukin-6 and hypersensitive C-reactive protein in the two groups were significantly lower than those before treatment, and those in the group B were significantly lower than those in the group A (all P < 0.05); The levels of maximum blood flow velocity, average blood flow velocity, and superoxide dismutase in the two groups were significantly higher than those before treatment, and those in the group B were significantly higher than those in the group A (all P < 0.05). There was no statistically significant difference in the occurrence of gingival bleeding, gastrointestinal reactions, dizziness, headache and intracranial hemorrhage between the two groups (P>0.05). Conclusion Edaravone dexborneol in combination with tirofiban showed better efficacy in patients with acute cerebral infarction, which may improve the effects of cerebral hemodynamics, oxidative stress and inflammation, however, had no significant effect on adverse reactions.
- Edaravone dexborneol /
- Tirofiban /
- Acute cerebral infarction /
- Cerebral hemodynamics /
- Oxidative stress

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表 1 2组急性脑梗死患者一般资料比较

Table 1. Comparison of general data between the two groups of patients with acute cerebral infarction

组别	例数	性别(例)		年龄 (x±s，岁)	病程 (x±s，h)	合并症(例)				梗死部位(例)			NIHSS评分 (x±s，分)
组别	例数	男性	女性	年龄 (x±s，岁)	病程 (x±s，h)	高血压	糖尿病	冠心病	高血脂	基底节	小脑	脑干	NIHSS评分 (x±s，分)
A组	108	52	56	61.39±12.99	21.27±5.12	55	11	6	57	61	23	24	6.43±1.24
B组	112	57	55	62.20±12.62	21.32±4.87	51	13	8	63	58	26	28	6.29±1.23
统计量		0.166^a		0.468^b	0.079^b	0.640^a	0.114^a	0.232^a	0.267^a	0.494^a			0.841^b
P值		0.684		0.641	0.937	0.424	0.735	0.630	0.605	0.781			0.402
注：^a为χ²值，^b为t值。

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表 2 2组急性脑梗死患者临床疗效比较(x±s，分)

Table 2. Comparison of clinical efficacy between the two groups of patients with acute cerebral infarction (x±s, points)

组别	例数	NIHSS评分
组别	例数	治疗前	治疗后
A组	108	6.43±1.24	3.67±0.77^a
B组	112	6.29±1.23	3.44±0.53^a
t值		0.841	2.589
P值		0.402	0.010
注：与治疗前比较，^aP < 0.05。

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表 3 2组急性脑梗死患者治疗前后脑血流动力学比较(x±s)

Table 3. Comparison of cerebral hemodynamics before and after treatment between the two groups of patients with acute cerebral infarction (x±s)

组别	例数	Vs(cm/s)		Vm(cm/s)		RI
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	108	66.38±11.54	75.61±10.46^a	52.45±7.45	58.55±8.62^a	0.72±0.23	0.64±0.17^a
B组	112	65.89±11.36	80.40±10.16^a	53.26±7.02	62.51±9.08^a	0.75±0.26	0.51±0.14^a
t值		0.317	3.446	0.830	3.315	0.905	6.201
P值		0.751	0.001	0.407	0.001	0.366	< 0.001
注：与同组治疗前比较，^aP < 0.05。

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表 4 2组急性脑梗死患者治疗前后氧化应激指标比较(x±s)

Table 4. Comparison of oxidative stress indexes before and after treatment between the two groups of patients with acute cerebral infarction (x±s)

组别	例数	MDA(mmol/L)		NE(pmol/L)		SOD(U/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	108	5.53±1.25	4.13±1.08^a	932.61±120.73	708.93±97.42^a	58.02±9.53	88.64±8.28^a
B组	112	5.46±1.22	3.73±0.93^a	936.47±131.68	665.49±88.50^a	59.62±9.38	96.26±8.85^a
t值		0.420	2.947	0.226	3.464	1.255	6.589
P值		0.675	0.004	0.821	0.001	0.211	< 0.001
注：与同组治疗前比较，^aP < 0.05。

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表 5 2组急性脑梗死患者治疗前后血清炎性因子指标比较(x±s)

Table 5. Comparison of serum inflammatory factors before and after treatment between the two groups of patients with acute cerebral infarction (x±s)

组别	例数	TNF-α(ng/L)		IL-6(ng/L)		hs-CRP(mg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	108	60.17±8.59	37.30±7.52^a	70.56±7.33	61.41±7.56^a	31.88±4.13	20.72±3.26^a
B组	112	59.62±8.16	27.76±9.11^a	71.29±7.69	56.69±7.50^a	30.72±4.72	15.84±3.36^a
t值		0.487	8.454	0.720	4.648	1.937	10.930
P值		0.627	< 0.001	0.472	< 0.001	0.054	< 0.001
注：与同组治疗前比较，^aP < 0.05。

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