| Objectives To investigate the effects of edaravone dexborneol combined with butylphthalide on the treatment efficiency,adverse reactions,90-day functional outcome,disease recurrence and early cognitive function in patients with acute cerebral infarction(ACI),and to analyze the changes of serum inflammatory factors before and after treatment.To provide clinical basis for the treatment of ACI.Methods 159 patients diagnosed with ACI for the first time in the third neurology department of Hebei General Hospital from January 2021 to October 2021 were included in the study.The patients were divided into observation group(82 cases)and control group(77 cases).Observation group was treated with ACI edaravone dexborneol injection concentrated solution combined with butylphthalide injection,while control group was treated with butylphthalide injection only.National institute of health stroke scale(NIHSS)scores were evaluated after 10 days of treatment in both groups Modified Rankin Scale(mRS)score of total clinical response rate,incidence of adverse reactions during treatment and follow-up at 90 days montreal cognitive assessment scale(MoCA)score was further analyzed for the levels of inflammatory factors in 53 patients in the observation group before and after treatment,and they were grouped according to the start time of medication and the severity of disease :1)Patients were divided into 48 hours group(48h group,29cases)and 48 hours to 7 days group(7d group,24cases)according to the start time of medication.2)NIHSS score was used to divide patients into mild stroke group(NIHSS≤ 4,32cases)and moderate stroke group(NIHSS: 5-15,21cases)NIHSS scores were evaluated in 2 groups before and after treatment,and serum IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γ,IL-17 A,Shh,CD200 levels were detected by venous blood samples before and after treatment.To analyze the effects of edaravone dexborneol combined with butylphthalide on the levels of inflammatory factors in patients with ACI of different degrees.Results 1 NIHSS score of 2 groups after treatment was significantly lower than that before treatment,the difference was statistically significant(P<0.05).2 the total effective rate of 10 d treatment in observation group was significantly higher than that in control group,the difference was statistically significant(91.50% vs 72.70%,P=0.002).3 patients in the two groups were followed up for 90 days,and there were more patients in the observation group with mRS≤1 than the control group,the difference was statistically significant(79.30% vs 64.90%,P=0.043).4 The incidence of disease recurrence in the observation group was less than that in the control group,but the difference was not statistically significant(7.30%<15.60%,P>0.05).5 The MMSE score of the observation group was significantly higher than that of the control group(23.03±4.39 vs 21.00±4.90,P=0.044).6 The number of cases of liver function impairment in the observation group was less than that in the control group,but the difference was not statistically significant(9.80%<15.60%,P>0.05).7 NIHSS scores of edaravon dexborneol combined with butylphthalide within 48 hours and 7 days after treatment were significantly lower than those before treatment(P<0.01).8 NIHSS scores of edaravon dexborneol combined with butylphthalide were significantly lower than those before treatment in mild stroke group and moderate and severe stroke group(P<0.01).9 The combination medication had a regulatory effect on serum inflammatory factors in patients with ACI for different drug duration: in the 48-hour group,TNF-α was significantly decreased,and Shh and CD200 levels were significantly increased after treatment,with statistical significance(TNF-α,P=0.001;Shh,P=0.023;CD200,P=0.035);TNF-α was significantly decreased in the 7-day group,the difference was statistically significant(P=0.007).After treatment,serum IL-6 and TNF-α levels in the mild stroke group decreased significantly,while serum Shh level increased,the difference was statistically significant(IL-6,P=0.018;TNF-α,P<0.01;Shh,P=0.012);TNF-α level was significantly decreased in the moderate stroke group after treatment,with statistical significance(P=0.031).Conclusions 1 Both edaravond dexborneol combined with butylphthalide and butylphthalide alone had good clinical efficacy in the treatment of ACI,and the total response rate,90-day functional outcome and cognitive function of the combined treatment were better than those of the single treatment.2 The combination of edaravone dexborneol and butylphthalide within 48 hours was more beneficial to the improvement of neurological deficits than that within 7 days.3 The combination of edaravone dexborneol and butylphthalide improved neurological deficits in patients with different severity of acute cerebral infarction.4 The combination of edaravone dexcamphenol and butylphthalide had a regulatory effect on serum inflammatory factors in patients with acute cerebral infarction and showed anti-inflammatory properties.Figure 0;Table 21;Reference 165... |
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