依达拉奉对急性脑梗死的疗效及其对出血性转化的影响

Effect of Edaravone on hemorrhagic transformation in treatment of acute cerebral infarction

摘要:

目的??探究依达拉奉联合阿替普酶治疗急性脑梗死的疗效及其对出血性转化（HT） 、 五聚素 3（PTX3） 与血浆脂蛋白相关磷脂酶 A2（Lp-PLA2）的影响。方法??选取 2014 年 1 月—2017 年 1 月承德医学院附属医院收治的 116 例急性脑梗死患者。根据随机数字表法分为观察组和对照组，每组 58 例。对照组给予阿替普酶治疗，观察组在对照组基础上给予依达拉奉治疗。 比较两组患者的临床疗效、 HT的发生率及治疗前后NIHSS评分、 ADL评分，同时监测治疗前后血清 PTX-3、Lp-PLA2 水平及治疗过程中不良反应发生率。结果??治疗后两组 NIHHS 评分均较治疗前降低（ P <0.05） ，且观察组低于对照组（ P <0.05） ； 对照组、观察组总有效率分别为 50.00% 和74.14%，观察组高于对照组（ P <0.05） ； 对照组、观察组出血性转化发生率分别为 24.14% 和 10.34%，观察组低于对照组（ P <0.05） ； 治疗后两组 PTX-3、 Lp-PLA2 均较治疗前下降（ P <0.05） ， 且观察组低于对照组（ P <0.05） ； 观察组和对照组不良反应总发生率为 10.34% 和 12.07%， 差异无统计学意义（ P >0.05） 。结论??依达拉奉联合阿替普酶治疗急性脑梗死， 可以有效改善神经功能缺损， 提高临床疗效， 预防出血性转化， 降低血清 Lp-PLA2、 PTX3 水平， 减轻炎症反应， 且安全性较好。

Abstract:

Objective To observe therapeutic effect of Edaravone plus Alteplase on hemorrhagic transformation in acute cerebral infarction patients. Methods A total of 116 cases with acute cerebral infarction admitted in our hospital during January 2014 to January 2017 were involved in this stud. They were randomly divided into observation group and control group (n = 58). Patients in control group were given Alteplase, and patients in the observation group were given Edaravone in addition to Alteplase. The NIHSS score and ADL score before and after treatment, curative effect, incidence of HT, serum PTX-3 and Lp-PLA2 before and after treatment, and adverse reactions were compared. Results The NIHHS scores were significantly reduced in both groups after treatment (P < 0.05), and patients in observation group experienced significant lowered score than that in control group (P < 0.05). The total effective rate in observation group was enhanced compared with control group (P < 0.05). The incidence of hemorrhagic conversion in observation group was increased when compared with that in control group (P < 0.05). Expression of PTX-3 and Lp-PLA2 decreased in observation group when compared with that in control group (P < 0.05). Total incidence of adverse reactions was comparable between observation group and control group (P < 0.05). Conclusions Edaravone combined with Alteplase effectively improves nerve function defect, and prevent hemorrhagic transformation in treatment of acute cerebral infarction.