Clinical efficacy of edaravone dexkanol in adjuvant treatment of acute cerebral infarction and its influence on cerebral circulation dynamics and hemorrhagic transformation
Objective To observe and analyze the clinical efficacy of edaravone dextrocamphorol in the adjuvant treatment of acute cerebral infarction(ACI)and its influence on cerebral circulation dynamics and hemorrhagic transformation(HT).Methods In this retrospective study,the subjects were 110 patients with ACI admitted to the Department of Neurology,the 17th Metallurgical Hospital of Ma'anshan City.The patients were divided into two groups by random number table method,with 55 in each group.Among the 110 patients,5 patients were excluded and 105 patients met the inclusion and exclusion criteria.Of the 105 patients,52 patients in the control group were given conventional treatment combined with butylphthalein sodium chloride injection,and 53 patients in the observation group were given edaravone dexcanol.The levels of cerebral circulation dynamics,oxidative stress indexes,serum growth factors,nerve markers and inflammatory factors were determined and analyzed before and after treatment to evaluate the clinical efficacy and safety.Results After treatment,the minimum blood flow velocity(Vmin)and minimum blood flow(Qmin)were increased in both groups,which were higher in the observation group((10.58±1.13)cm·s-1,(5.38±0.82)mL·s-1,respectively)than in the control((9.63±1.07)cm·s-1,(4.79±0.69)mL·s-1).The cerebrovascular resistance(R)and pulse wave velocity(WV)decreased in both groups and they were significantly lower in the observation group((1 736.59±167.58)(Pa·s)·mL-1,(19.07±3.06)m·s-1)than in the control((1 881.64±171.52)(Pa·s)·mL-1,(20.89±3.15)m·s-1),the difference was statistically significant(P＜0.05).The superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),vascular endothelial growth factor(VEGF),insulin-like growth factor-1(IGF-1)and brain-derived neurotrophic factor(BDNF)were increased while oxidative stress index(MDA),central nerve specific protein(S100β),neuron-specific enolase(NSE),trypophenin-like protein-1(VILIP-1),hypersensitive C-reactive protein(hs-CRP),matrix metalloproteinase-9(MMP-9),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)decreased after treatment as compared with those before the treatment in both groups,the difference was statistically significant(P＜0.05).SOD,GSH-Px,VEGF,IGF-1 and BDNF in the observation group were(121.62±14.75)U·mL-1,(70.19±5.07)μmol·L-1,(316.27±31.52)pg·mL-1,(161.82±18.65)ng·mL-1 and(32.83±3.89)pg·mL-1,which were higher higher than those of(106.58±11.67)U·mL-1,(61.34±4.29)μmol·L-1,(291.61±28.73)pg·mL-1,(145.07±15.94)ng·mL-1 and(27.26±3.53)pg·mL-1 in the control(P＜0.05).However,the MDA,S100β,NSE,VILP-1,hs-CRP,MMP-9,TNF-α and IL-6 were(5.08±0.59)mmol·L-1,(1.92±0.18)ng·mL-1,(6.34±0.72)ng·mL-1,(331.91±29.73)pg·mL-1,(4.16±0.62)μmol·L-1,(101.51±18.04)ng·mL-1,(20.37±5.08)ng·L-1 and(35.91±5.07)ng·L-1,which were significantly lower than those of(7.15±0.73)mmol·L-1,(2.44±0.35)ng·mL-1,(8.62±0.89)ng·mL-1,(395.78±32.18)pg·m L-1,(6.27±0.73)μmol·L-1,(119.83±18.67)ng·mL-1,(25.38±5.27)ng·L-1,(40.08±5.26)ng·L-1 in the control(P＜0.05).The incidence of HT was significantly lower in the observation group than in the control(7.55%vs 17.31%,P＜0.05).The total clinical effective rate in the observation group was 94.34%,which was better than that of 82.69%in the control(P＜0.05).Serious adverse events occurred in both groups during treatment.Conclusion Edaravone used in adjuvant treatment of ACI can significantly improve cerebral circulation dynamics,reduce the occurrence of HT,and has outstanding efficacy.The mechanism of which might be related to reducing oxidative stress,anti-inflammatory effect,and promoting the expression of serum growth factor.
万方数据
维普
