依达拉奉在急性脑梗死静脉溶栓再灌注损伤中应用效果及保护作用机制研究

目的 分析依达拉奉在急性脑梗死(acute cerebral infarct,ACI)静脉溶栓再灌注损伤中应用效果及保护作用.方法 选择2012年1月-2016年1月诊治的符合静脉溶栓指标的ACI 118例,根据治疗方式分为观察组和对照组,每组59例.对照组在常规综合治疗的基础上,给予尿激酶静脉溶栓治疗,观察组在对照组基础上给予依达拉奉注射液治疗,连续治疗2周.观察2组治疗前后血清超氧化物歧化酶(SOD)、丙二醛(MDA)、神经元特异性烯醇化酶(NSE)、血管内皮素(ET)、超敏C反应蛋白(hs-CRP)、美国国立卫生院神经功能缺损量表(NIHSS)评分、日常生活能力评分(ADL)、临床效果及安全性.结果 与治疗前比较,治疗后2组SOD活力、ADL评分升高,MDA和NSE、ET和hs-CRP含量及NIHSS评分降低,且2组间比较差异有统计学意义(P＜0.01).观察组总有效率高于对照组(P＜0.05).2组均未发生不良反应.结论 应用依达拉奉治疗ACI可显著改善静脉溶栓后再灌注损伤状况和神经功能,提高生活质量,疗效显著,安全性较高.

Application Effect and Protection Mechanism of Edaravone in Treatment of Reperfusion Injury of Patients with Acute Cerebral Infarction after Intravenous Thrombolysis

Objective To analyze application effect and protection mechanism of Edaravone in treatment of reperfusion injury of patients with acute cerebral infarction (ACI) after intravenous thrombolysis.Methods A total of 118 ACI patients met intravenous thrombolytic indexes admitted between January 2012 and January 2016 were divided into control group and observation group according to different treatment methods (n =59 for each group).Control group was given Urokinase venous thrombolytic therapy on the basis of routine comprehensive treatment,while observation group was treated with Edaravone injection for 2 weeks continuously on the basis of treatment for control group.Serum superoxide dismutase (SOD),malondialdehyde (MDA),neuron specific enolase (NSE),endothelin (ET),high-sensitivity C reactive protein (hs-CRP),neural function defect score national institute of health stroke scale (NIHSS)],activities of daily living (ADL) score,clinical effects and safety were observed before and after treatment in two groups.Results Compared with those before treatment,values of SOD activity and ADL scores were significantly increased,while values of MDA,NSE,ET,hs-CRP content and NIHSS scores were significantly decreased,and there were significant differences in the values between two groups (P ＜ 0.01).The total effective rate in observation group was significantly higher than that in control group (P ＜ 0.05).There was no significant adverse reaction in two groups.Conclusion Application of Edaravone in treatment of patients with acute cerebral infarction can significantly relieve reperfusion injury after in travenous thrombolysis and effectively improve neurologic function and quality of life with good effectiveness and safety.