目的:探讨依达拉奉右莰醇对后循环急性脑梗死患者的影响.方法:按照随机数字表法将我院 2021 年 4 月至 2023 年 4 月后循环急性脑梗死患者 129 例分为两组,对照组 64 例给予 0.9 mg·kg-1 阿替普酶静脉溶栓+100 mg阿司匹林肠溶片口服治疗,观察组 65 例在此基础上增加 15 mL依达拉奉右莰醇静脉滴注治疗.治疗 14 d后,依据美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)得分情况评估临床疗效;观察两组治疗前、治疗 14 d后以酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)检测的神经元特异性烯醇化酶(Neuron-specific enolase,NSE)、中枢神经特异性蛋白(Central nervous system specific protein-β,S100-β)水平,以化学发光法检测多胺氧化酶(Polyamine oxidase,PAO)水平,经颅多普勒超声检测的大脑后动脉、椎动脉、基底动脉收缩期峰血流速度(Peak systolic velocity,PSV)、阻力指数(Resistance Index,RI)以及定量脑电图检测患侧δ、θ频段绝对功率值、慢波化比率(Deltaratio Symmetry theta/alpha+beta rate,DTABR);并统计两组治疗期间不良反应的发生情况.结果:与对照组相比,观察组总有效率、大脑后动脉、椎动脉、基底动脉PSV更高,RI、NSE、S100-β、PAO、δ、θ频段绝对功率值及DTABR更低(P＜0.05);治疗期间无不良反应.结论:在后循环急性脑梗死患者中使用依达拉奉右莰醇疗效显著,可有效改善患者后循环血流动力学和脑电活动,抑制脑神经损伤.
Effects of intravenous infusion of edaravone on patients with acute cerebral infarction in posterior circulation
Objective:To investigate the effects of edaravone on patients with acute cerebral infarction in posterior circulation.Method:A total of 129 patients with acute cerebral infarction in our hospital from April 2021 to April 2023 were divided into two groups by random number table method,the control group consisted of 64 patients who received intravenous thrombolysis with 0.9 mg·kg-1 alteplase and oral administration of 100 mg aspirin enteric coated tablets.The observation group consisted of 65 patients who received an intravenous infusion of 15 mL of edaravone and right camphor in addition to this treatment.After 14 days of treatment,the clinical efficacy was evaluated according to the score of the National Institute of Health Stroke Scale(NIHSS).Before and after treatment for 14 days,the levels of neuron-specific enolase(NSE)and central nervous system-specific protein-β(S100-β)were detected by enzyme-linked immunosorbent assay(ELISA),the levels of polyamine oxidase(PAO)was detected by the chemiluminescence method,and Peak systolic velocity(PSV)and Resistance Index(RI)of a posterior cerebral artery,vertebral artery and basilar artery were detected by transcranial Doppler and absolute power value and the delta ratio symmetry theta/alpha+beta rate(DTABR)were detected by quantitative EEG.The occurrence of adverse reactions during the treatment of the two groups was counted.Result:Compared with the control group,the total effective rate,and peak systolic velocity(PSV)of the posterior cerebral artery,vertebral artery,and basilar artery in the observation group was higher,and the levels of RI,NSE,S100-β,PAO,and the absolute power values in δ and θ bands and DTABR were lower(P<0.05).There were no adverse reactions during the treatment.Conclusion:In patients with acute cerebral infarction in the posterior circulation,edaravone has a significant effect,which can effectively improve the hemodynamics and EEG activity in the posterior circulation and inhibit brain nerve injury.
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