摘要
目的探讨依达拉奉对急性脑梗死患者rt—PA静脉溶栓后MMP-9表达及出血性转化的影响。方法选择204例早期（发病后就诊时间〈4．5h）急性脑梗死患者，按照随机数字表分为两组：依达拉奉组（102例，转院2例，完成100例）和对照组（102例）。在常规治疗的基础上，依达拉奉组入院后即开始应用依达拉奉注射液30mg＋生理盐水100mL静脉滴注，30min滴完，2次／d，连用14d；对照组入院后即开始应用胞二磷胆碱注射液200mg＋生理盐水100mL，静脉滴注，2次／d，连用14d。观察两组患者的临床疗效、MMP-水平、出血性转化发生率及药物不良反应。结果①治疗14d后，两组患者NIHSS评分及Barthel指数均较治疗前显著改善（依达拉奉组：t=26．369，34．875，均P〈0．01；对照组：t=16．041，26．952，均P〈0．01），依达拉奉组较对照组改善更显著（均P〈0．01）。②依达拉奉组的血清MMP-9水平在各时间点（溶栓后12h及第2、3、7、15天）均低于对照组（均P〈0．01）。③依达拉奉组患者出血性转化率低于对照组（x2=4．5830，P〈0．05）。④两组患者的不良反应发生率差异无统计学意义（x2=0．1341，P〉0．05）。结论依达拉奉能显著降低急性脑梗死患者rt—PA静脉溶栓后MMP-9表达，并能降低溶栓后出血转化率，且安全性好。
Objective To study the effect of edaravone on level of serum metallopmteinase -9 and hemorrhagic transformation after intravenous thrombolysis in patients with acute cerebral infarction. Methods 204 patients with early acute cerebral infarction （the length of time between attack and reception 〈 4.5 h） were divided into two group according to the digital table method： the edaravone group （ 102 cases, loss to follow - up 2 cases, complete 100 cases） and the control group （ complete 102 cases）. On the basis of conventional treatment, the edaravone group was treated with edaravone injection immediately after admission, edaravone injection 30 mg ＋ normal saline 100 mL/intravenous drip, 30 min application completed, twice per day, for 14 days; the control group was treated with eiticoline injection immediately after admission, citieoline injection 200 mg ＋ normal saline 100 mL/intravenous drip, twice per day, for 14 days. To observe the clinical efficacy, MMP -9 level, hemorrhagic conversion rate and adverse drug reaction of two groups. Results ①After 14 days treatment, NIHSS score and Barthel index were significantly improved compared with before treatment in patients of two groups （the edaravone group： t = 26. 369, 34. 875, all P 〈 0.01 ; the control group： t = 16. 041, 26.952, all P 〈 0.01 ）, the edaravone group improved more significantly than the control group （ all P 〈 0.01 ）. ②After 14 days treatment, the serum level of MMP - 9 of the edaravone group was lower than that of the control group at each time point （12 h and 2, 3, 7, 15 days after thrombolysis; all P 〈 0.01 ）. ③Hemorrhagic transformation rate of the edaravone group was lower than those of the control group within 14 days ＇of treatment （ x2 = 4. 5830, P 〈 0.05）. ④There was no significant difference in the incidence of adverse reactions between the two groups （x2 = 0. 1341, P 〉 0.05）. Conclusion Edaravone can significantly reduce the expression of MMP - 9 rt - PA in acute cerebral infarction patients after intravenous thrombolysis, and it can reduce the rate of hemorrhagic transformation after thrombolysis, and the safety is good.
出处
《中国急救医学》
CAS
CSCD
北大核心
2016年第10期913-917,共5页
Chinese Journal of Critical Care Medicine
关键词
急性脑梗死
早期
重组组织型纤溶酶原激活剂
静脉溶栓
依达拉奉
基质金属蛋白酶
出血性转化
Acute cerebral infarction, early
Recombinant tissue plasminogen activator
Intravenous thrombolysis
Edaravone
Matrix metalloproteinase
Hemorrhagic transformation
