依达拉奉右莰醇联合尤瑞克林治疗轻中度急性血栓性脑梗死的临床效果

Clinical effect of edaravone dexborneol combined with urinary kallidinogenase in the treatment of mild-to-moderate acute thrombotic cerebral infarction

  • 摘要:
    目的 探讨依达拉奉右莰醇联合尤瑞克林治疗轻中度急性血栓性脑梗死的临床效果及其对血栓弹力图参数、血管性血友病因子(vWF)等指标的影响。
    方法 选取100例轻中度急性血栓性脑梗死患者作为研究对象,采用随机数字表法将其分为2组,每组50例。对照组给予常规治疗(阿司匹林联合氯吡格雷抗血小板治疗),观察组在对照组基础上加用依达拉奉右莰醇联合尤瑞克林治疗,均治疗10 d。比较2组血栓弹力图参数血凝块形成时间(K值)、凝血反应时间(R值)、凝固角(Angle角)、血栓最大振幅(MA值)、凝血综合指数(CI值)、vWF、血小板聚集率、脑血流动力学指标大脑中动脉、基底动脉的平均血流速度及搏动指数、氧化应激指标超氧化物歧化酶(SOD)、丙二醛(MDA)水平、神经功能血清神经元特异性烯醇化酶(NSE)、S100β蛋白、美国国立卫生研究院卒中量表(NIHSS)评分及不良反应。
    结果 治疗10 d时,观察组K值、R值、SOD水平均高于对照组, Angle角、MA值、CI值、血小板聚集率和vWF、MDA、NSE、S100β蛋白水平及NIHSS评分均低于对照组,差异有统计学意义(P < 0.05); 治疗10 d时, 2组大脑中动脉、基底动脉的平均血流速度均高于治疗前,搏动指数均低于治疗前,且观察组平均血流速度高于对照组,搏动指数低于对照组,差异有统计学意义(P < 0.05)。2组不良反应发生率比较,差异无统计学意义(χ2=0.379, P=0.538)。
    结论 依达拉奉右莰醇联合尤瑞克林治疗可改善轻中度急性血栓性脑梗死患者的血栓弹力图参数、脑血流动力学指标, 降低vWF水平及血小板聚集率,减轻机体氧化应激反应,促进神经功能恢复,且安全性较好。

     

    Abstract:
    Objective To investigate the clinical effect of edaravone dexborneol combined with urinary kallidinogenase in the treatment of mild-to-moderate acute thrombotic cerebral infarction and its impact on thromboelastography parameters, von Willebrand factor (vWF), and other indicators.
    Methods A total of 100 patients with mild-to-moderate acute thrombotic cerebral infarction were selected as the study subjects and randomly divided into two groups using a random number table method, with 50 cases in each group. The control group received conventional treatment (antiplatelet therapy with aspirin combined with clopidogrel), while the observation group received edaravone dexborneol combined with urinary kallidinogenase in addition to the control group's treatment. Both groups were treated for 10 days. Thromboelastography parameters clot formation time (K value), coagulation reaction time (R value), clot angle (Angle value), maximum amplitude of thrombus (MA value), and comprehensive coagulation index (CI value), vWF, platelet aggregation rate, cerebral hemodynamic indicators mean blood flow velocity and pulsatility index of the middle cerebral artery and basilar artery, oxidative stress indicators superoxide dismutase (SOD) and malondialdehyde (MDA), neurological function serum neuron-specific enolase (NSE), S100β protein, and National Institutes of Health Stroke Scale (NIHSS) score, and adverse reactions were compared between the two groups.
    Results At 10 days of treatment, the K value, R value, and SOD level in the observation group were higher than those in the control group, while the Angle value, MA value, CI value, platelet aggregation rate, vWF, MDA, NSE, S100β protein levels, and NIHSS score were lower than those in the control group, with statistically significant differences (P < 0.05). At 10 days of treatment, the mean blood flow velocities of the middle cerebral artery and basilar artery in both groupswere higher than those before treatment, and the pulsatility indices were lower than those before treatment. Moreover, the mean blood flow velocity in the observation group was higher than that in the control group, and the pulsatility index was lower than that in the control group, with statistically significant differences (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ2=0.379, P=0.538).
    Conclusion Edaravone dexborneol combined with urinary kallidinogenase treatment can improve thromboelastography parameters and cerebral hemodynamic indicators in patients with mild-to-moderate acute thrombotic cerebral infarction, reduce vWF levels and platelet aggregation rate, alleviate oxidative stress reactions, promote neurological function recovery, and has good safety.

     

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