依达拉奉右莰醇注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效分析

Therapeutic evaluation of edaravone dexborneol injection combined with intravenous alteplase in acute ischemic stroke

摘要:

目的 分析依达拉奉右莰醇注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效。方法 选取2022年6月—2025年6月在长安医院确诊的急性缺血性脑卒中患者100例，依据1∶1比例分为对照组（50例，阿替普酶静脉溶栓治疗）和试验组（50例，依达拉奉右莰醇注射液联合阿替普酶静脉溶栓治疗）。比较两组的疗效、脑血管血流动力学指标［脉搏波波速（Wv）、血流速度最小值（V_min）、动态阻抗（DR）、外周阻力（R）］、神经功能［神经功能缺损程度（NDS）评分、美国国立卫生研究院卒中量表（NIHSS）评分］、氧化应激状况［丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH-Px）、超氧化物歧化酶（SOD）］、内皮素-1（ET-1）、细胞间黏附分子-1（ICAM-1）、基质金属蛋白酶-9（MMP-9）、不良反应（恶心呕吐、发热、皮疹、胃肠道反应、血尿）。结果 试验组治疗总有效率高于对照组（P <0.05）；试验组治疗后Wv、DR、R均低于对照组，V_min高于对照组（P <0.05）；试验组治疗后NDS评分、NIHSS评分均低于对照组（P <0.05）；试验组治疗后MDA低于对照组，GSH-Px、SOD高于对照组（P <0.05）；试验组治疗后ET-1、ICAM-1、MMP-9水平低于对照组（P <0.05）。试验组与对照组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 依达拉奉右莰醇联合阿替普酶溶栓可产生协同神经保护效应，不仅提升临床疗效，还能改善脑血流动力学参数并促进神经功能恢复，减轻氧化应激及炎症反应，且安全性较好。

Abstract:

Objective This study aimed to assess the therapeutic value of combining edaravone dexborneol injection with intravenous alteplase in the management of acute ischemic stroke (AIS).Methods One hundred patients diagnosed with AIS between June 2022 and June 2025 were enrolled and randomly allocated to either the control group (n = 50, receiving alteplase alone) or the experimental group (n = 50, receiving edaravone dexborneol plus alteplase). Clinical efficacy was evaluated by comparing cerebrovascular hemodynamic parameters [pulse wave velocity (Wv), minimum blood flow velocity (V_min), dynamic resistance (DR), peripheral resistance (R) ], neurological function [neurological deficit scale (NDS) and National Institutes of Health Stroke Scale (NIHSS) ], oxidative stress markers [malondialdehyde (MDA), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) ], as well as serum ET-1, ICAM-1, and MMP-9 levels. Adverse events were also recorded.Results The total effective rate in the experimental group was significantly higher than that in the control group (P < 0.05). After treatment, Wv, DR, and R were significantly lower and V_min was significantly higher in the experimental group than in the control group (P < 0.05). The NDS and NIHSS scores were significantly lower in the experimental group than in the control group (P < 0.05). The level of MDA was significantly lower, while GSH-Px and SOD levels were significantly higher in the experimental group than in the control group (P < 0.05). In addition, ET-1, ICAM-1, and MMP-9 levels were significantly lower in the experimental group than in the control group (P < 0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P > 0.05).Conclusion Edaravone dexborneol injection combined with intravenous alteplase thrombolysis can improve treatment efficacy in acute ischemic stroke, enhance cerebral hemodynamics and neurological function, alleviate oxidative stress and inflammatory injury, and shows good safety.