Clinical effect of rt-PA combined with edaravone dexborneol for patients with ischemic stroke
Objective To evaluate the effect of intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rt-PA)combined with edaravone dexborneol on neurologic function and oxidative stress in patients with ischemic stroke(IS).Methods Seventy-eight patients with IS treated in Baoji Gaoxin Hospital from January 2020 to October 2023 were selected for the randomized controlled trial.They were divided into a control group and an observation group by the random number table method,with 39 cases in each group.There were 23 males and 16 females in the control group;they were(63.03±6.42)years old;their disease course was(31.12±6.43)h.There were 22 males and 17 females in the observation group;they were(62.88± 6.29)years old;their disease course was(30.74±6.39)h.The control group took intravenous thrombolysis by rt-PA;in addition,the observation group were treated with edaravone dexborneol.The treatment efficacies,scores of neurological function[National Institutes of Health Stroke Scale(NIHSS)and modified Rankin Scale(mRS)],and levels of oxidative stress indicators[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),malondialdehyde(MDA),and reactive oxygen species(ROS)]and inflammatory markers[interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-alpha),and high-sensitivity c-reactive protein(hs-CRP)]were compared between the two groups.x2 and t tests were applied.Results After two weeks'treatment,the overall efficacy in the observation group was higher than in the control group[79.49％(31/39)vs.56.41％(22/39)],with a statistical difference(x2=4.77;P＜0.05).After two weeks'treatment,the scores of NIHSS and mRS in the observation group were lower than those in the control group[(7.87±0.96)vs.(9.88±1.83)and(1.78±0.14)vs.(2.04±0.21)],with statistical differences(t=6.07 and 6.43;both P＜0.05).After two weeks'treatment,the levels of GSH Px,SOD,MDA,and ROS in the observation group were better than those in the control group[(219.78±24.13)mg/L vs.(189.88±23.12)mg/L,(154.78±11.95)U/ml vs.(138.67±13.16)U/ml,(47.01±5.64)μmol/L vs.(51.94±6.34)μmol/L,and(508.57±36.34)μmol/L vs.(576.34±38.44)μmol/L],with statistical differences(t=5.59,5.66,3.63,and 8.00;all P＜0.05).After two weeks'treatment,the serum levels of IL-6,TNF-α,and hs-CRP in the observation group were lower than those in the control group[(8.45±3.12)ng/L vs.(13.67±3.96)ng/L,(0.72±0.28)ng/L vs.(1.23±0.34)ng/L,and(9.67±4.28)ng/L vs.(14.78±4.55)ng/L],with statistical differences(t=6.47,7.23,and 5.11;all P＜0.05).Conclusion Intravenous thrombolysis by rt-PA combined with edaravone dexborneol for patients with IS can significantly improve the treatment efficacy and their neurological function and reduce the levels of oxidative stress and inflammatory factors,and has better therapeutic effects than rt-PA alone.
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