The Clinical Efficacy Of Alteplase Combined With Edaravone Dexborneol On Acute Ischemic Stroke

Objective:In order to observe the effect of rt-PA combined with Edaravond Dexborneol on the reduction of disability in patients with acute ischemic stroke after thrombolytic therapy,and verify its clinical efficacy and safety.Providing objective evidence for clinical use and reducing the rate of severe disability and morbidity and mortality to improve patients outcomes.Methods:In this study,60 patients with acute cerebral infarction admited to The Second Hospital of Hebei Medical University were enrolled,which were divided into control group（rt-PA+ischemic stroke standard therapy）and treatment group（rt-PA+Edaravond Dexborneol+ischemic stroke standard therapy）,and each group has 30 patients.Baseline information such as age,gender,past medical history（Whether there is a history of hypertension,diabetes,coronary heart disease,stroke,etc.）,smoking history,drinking history and imaging data were collected.NIHSS scores and m RS Scores were recorded and compared before thrombolysis,12d and 90d after thrombolysis.Blood samples were collected before and after treatment.The levels of TXNIP,HO-1,MDA and SOD in serum of the two groups were detected and compared by ELISA kits.According to the90d prognosis,patients were divided into good prognosis group（m RS≤2points）and poor prognosis group（m RS>2 points）^[1].Further statistical analysis was conducted on the prognosis of patients and whether there was hemorrhagic transformation on imaging in the 12d after the thrombolysis.Results:1.A total of 60 patients were brought into this study,including 24 males（80.0%）and 6 females（20.0%）in the control group,with an average age of63.13±2.15 years,22 males（73.3%）and 8 females（26.7%）in the treatment group,with an average age of 60.77±1.63 years.In the control group,27cases（90.0%）had good prognosis and 3 cases（10.0%）had poor prognosis.In the treatment group,29 cases（96.7%）had good prognosis,and 1 case（3.3%）had poor prognosis.In the control group,11 cases（36.7%）showed hemorrhagic transformation and 19 cases（63.3%）did not.In the treatment group,5 cases（16.7%）showed hemorrhagic transformation and 25 cases（83.3%）did not.2.There were no statistically significant differences in gender,age,past medical history（including whether there is a history of hypertension,diabetes,coronary heart disease,stroke,etc.）,smoking history,drinking history and other general baseline data collected between the two groups（P>0.05）.There was no significant difference in prognosis between the treatment group and the control group（χ²=3.068,P=0.08）.There was no significant difference in the rate of hemorrhage after thrombolysis between the two groups（χ²=0.268,P=0.605）.3.NIHSS score and m RS Score before thrombolysis were not significantly different between the two groups（P>0.05）,[（4.24±0.61 vs.6.17±0.88）,P=0.150;（2.03±0.27 vs.2.57±0.25）,P=0.173].NIHSS scores and m RS Scores in the treatment group were lower than those in the control group at the 12d after thrombolysis（P<0.05）,[（2.34±0.35 vs.3.73±0.47）,P=0.036;（1.21±0.18 vs.1.87±0.21）,P=0.029].On the 90th day after thrombolysis,NIHSS scores and m RS Scores in the treatment group were also lower than those in the control group（P<0.05）,[（1.18±0.28 vs.2.13±0.37）,P=0.042;（0.43±0.14 vs.1.03±0.20）,P=0.012].4.There were no significant differences in TXNIP,HO-1,MDA and SOD levels between 2 groups before thrombolysis（P>0.05）.Compared with the control group,TXNIP,HO-1 and SOD levels were higher and MDA levels were lower in the treatment group at 24h and 12d after thrombolysis,and only TXNIP had statistical differences among the above indexes（P<0.05）.5.Compared with before thrombolysis,TXNIP,HO-1 and SOD levels were lower and MDA levels were higher in the control group at 24h after thrombolysis;HO-1 level was higher,TXNIP,MDA and SOD levels were lower in the treatment group.On the 12d after thrombolysis,TXNIP,MDA and SOD levels in both groups were decreased,while HO-1 levels in the treatment group were increased compared with those before thrombolysis.Conclusion:Alteplase combined with Edaravone Dexborneol in the sequential treatment of patients with acute ischemic stroke has definite clinical efficacy,which can effectively improve the symptoms of neurological impairment and clinical prognosis of patients.Whether its anti-oxidative stress mechanism is related to the regulation of TXNIP related signaling pathways needs further investigation.