| Objective To observe the changes of NIHSS score,m RS score,BI score and the effect on serum TNF-α,hs-CRP and MMP-9 after the treatment of acute ischemic stroke(AIS)after intravenous thrombolytic injection of edaravone dexborneol after rt-PA,and to explore its clinical efficacy and possible mechanism.Methods A total of 100 patients with acute ischemic stroke who received intravenous thrombolysis with alteplase in our hospital from December 2021 to December 2022 were selected and randomly divided into experimental group and control group,with 50 cases in each group.In the experimental group,3 cases were discharged early and 2 cases were transferred to other departments.In the control group,4 cases were discharged early and 1 case was treated in another hospital due to lymphoma.A total of 90 patients were enrolled,45 in the experimental group and 45 in the control group.The control group was given conventional treatment such as improving cerebral blood supply,nutrition of brain cells and anti-platelet according to the guidelines for the diagnosis and treatment of acute ischemic stroke in China 2018.The experimental group was given edaravone dexborneol on the basis of the conventional treatment of the control group,with a dose of 15 ml added to 100 ml normal saline by intravenous drip,twice a day for 10 days.The risk factors of cerebral infarction were controlled to normal levels in both groups.The National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin scale(m RS)score,Barthel index(BI)score of the two groups were observed 10±2 days and 90±7 days after treatment,and the efficacy and adverse reactions were observed.The serum levels of tumor necrosis factor-α(TNF-α),highsensitivity C-reactive protein(hs-CRP)and matrix metalloproteinase 9(MMP-9)were detected.SPSS26.0 statistical software was used to analyze the data.Results 1.There was no significant difference in gender,age,hypertension and diabetes between the two groups before treatment,P > 0.05,which was comparable.2.The NIHSS score of the two groups decreased compared with before treatment on the 10±2 days and 90±7 days,and the difference was statistically significant(P<0.01);on the 10±2 days and 90±7 days,the NIHSS score of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).3.Compared with before treatment,the m RS score of the two groups decreased on the 10±2 days and 90±7 days,and the difference was statistically significant(P<0.01);on the 10±2 days and 90±7 days,the m RS score of the experimental group was lower than that of the control group,and the difference was statistically significant(P< 0.05).4.The BI score of the two groups was higher than that before treatment on the 10±2 days and 90±7 days,and the difference was statistically significant(P<0.01);on the 10±2 days and 90±7 days,the BI score of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).5.On the 10±2nd day after treatment,the total efficiency of the experimental group was 95.56%,the total efficiency of the control group was 82.22%,and the total efficiency of the experimental group was higher than that of the control group.The difference was statistically significant(P<0.05).6.The levels of TNF-α,hs-CRP and MMP-9 decreased in the 10±2 days of patients in the two groups compared with those before treatment,and the differences were statistically significant(P<0.01);on the 10±2 days,the experimental group compared with the control group,the TNF-α,hs-CRP and MMP-9 levels In the control group,the difference is statistically significant(P<0.05).7.In the experimental group,there was a mild increase of transaminase in 1 case,1 case of gastrointestinal reaction,and the incidence of adverse reactions was 4.44%.In the control group,there was 1 case of intracranial hemorrhage and 2 cases of gastrointestinal reactions.The incidence of adverse reactions was 6.67%.The incidence of adverse reactions in the two groups is not statistically significant(P<0.05).Conclusion The early use of edaravone dexborneol in the treatment of AIS patients after intravenous thrombolysis with alteplase has a significant decrease in NIHSS and m RS Scores,a significant increase in BI scores,and a significant improvement in neurological function and activities of daily living.The serum levels of TNF-α,hs-CRP and MMP-9 in edaravone dexborneol group were significantly lower than those in control group,suggesting that edaravone dexborneol may play a neuroprotective role by reducing inflammatory response and protecting blood-brain barrier.In addition,edaravone dexborneol is safe in the early treatment of AIS after intravenous thrombolysis with alteplase. |
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