摘要
目的探讨依达拉奉在急性脑梗死患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后出血性转化(HT)中的作用。方法选取2017年1月~2018年12月凉山彝族自治州第二人民医院行rt-PA溶栓治疗的急性脑梗死患者98例,根据治疗方式的不同分为对照组(50例)和研究组(48例),对照组予以rt-PA静脉溶栓及常规治疗,研究组在对照组基础上联合依达拉奉,比较两组患者血清指标[基质金属蛋白酶-9(MMP-9)、血浆胶质纤维酸性蛋白(GFAP)、血浆细胞纤维连接蛋白(c-Fn)]、美国国立卫生研究院卒中量表(NIHSS)评分及Barthel指数,记录两组患者治疗期间不良反应情况。结果两组患者治疗后第1、3天MMP-9、GFAP、c-Fn水平高于治疗前,治疗后第7、14天各指标水平低于治疗前,且治疗时间越长,各指标水平越低,差异有统计学意义(P <0.05)。研究组治疗后第3、7、14天MMP-9、GFAP、c-Fn水平低于对照组,差异有统计学意义(P <0.05)。此外,两组患者各指标交互作用差异有统计学意义(P <0.05)。治疗后第14天,两组患者NIHSS评分低于治疗前,且研究组低于对照组;Barthel指数高于治疗前,且研究组高于对照组,差异有统计学意义(P <0.05)。研究组HT总发生率低于对照组,差异有统计学意义(P <0.05)。两组患者不良反应发生率比较,差异无统计学意义(P> 0.05)。结论依达拉奉可减少HT发生,改善患者生活自理能力,减轻神经功能损害,用药安全性较好,可能与其下调MMP-9、GFAP、c-Fn等因子水平有关。
Objective To investigate the effect of Edaravone in the hemorrhagic transformation(HT)after intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction.Methods From January 2017 to December 2018,a total of 98 patients with acute cerebral infarction who were treated with rt-PA thrombolysis in the Second People′s Hospital of Liangshan Yi Autonomous Prefecture were selected and divided into control group(50 cases)and study group(48 cases)according to different treatment methods.The control group was treated with rt-PA intravenous thrombolysis and routine treatment.The study group was combined with Edaravone on the basis of the control group.The serum indexes(Matrix metalloproteinase-9[MMP-9],plasma glial fibrillary acidic protein[GFAP],plasma cellular fibronectin[c-Fn]),national institutes of health stroke scale(NIHSS)score and Barthel index of two groups were compared.Adverse reactions during treatment between the two groups were recorded.Results The levels of MMP-9,GFAP and c-Fn in the two groups on days 1 and 3 were higher than those before treatment,and the index levels on days 7 and 14 were lower than before treatment,while the time after treatment was longer,the index levels were lower,and the differences were statistically significant(P<0.05).The levels of MMP-9,GFAP,and c-Fn on the 3 rd,7 th,and 14 th days of treatment in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).In addition,the difference in the interaction of the indicators of the two groups was statistically significant(P<0.05).Onthe 14 th day of treatment,the NIHSS score of the two groups were lower than before treatment,and the study group was lower than the control group;the Barthel index were higher than before treatment,and the study group was higher than the control group,the differences were statistically significant(P<0.05).The total incidence of HT in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion Edaravone can reduce the incidence of HT,improve the ability of self-care,reduce the damage of nerve function,and the safety of medication is better,which may be related to the down-regulation of MMP-9,GFAP,c-Fn and other factors.
作者
许春梅
樊蓉
张丽
XU Chunmei;FAN Rong;ZHANG Li(Department of Neurology,the Second People's Hospital of Liangshan Yi Autonomous Prefecture,Sichuan Province,Xichang 615000,China;Department of Obstetrics and Gynecology,the 63790 Military Hospital of the People's Liberation Army of China,Sichuan Province,Xichang 615000,China;Department of Pediatrics,Children's Hospital of Chongqing Medical University,Chongqing 401122,China)
出处
《中国医药导报》
CAS
2020年第17期79-83,共5页
China Medical Herald
基金
四川省卫计委科研课题(160416)。
关键词
依达拉奉
急性脑梗死
重组组织型纤溶酶原激活剂静脉溶栓
出血性转化
Edaravone
Acute cerebral infarction
Recombinant tissue plasminogen activator intravenous thrombolysis
Hemorrhagic transformation
