依达拉奉在急性脑梗死患者rt-PA静脉溶栓后出血性转化中的作用

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Abstract Objective To investigate the effect of Edaravone in the hemorrhagic transformation (HT) after intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in patients with acute cerebral infarction. Methods From January 2017 to December 2018, a total of 98 patients with acute cerebral infarction who were treated with rt-PA thrombolysis in the Second People′s Hospital of Liangshan Yi Autonomous Prefecture were selected and divided into control group (50 cases) and study group (48 cases) according to different treatment methods. The control group was treated with rt-PA intravenous thrombolysis and routine treatment. The study group was combined with Edaravone on the basis of the control group. The serum indexes (Matrix metalloproteinase-9 [MMP-9], plasma glial fibrillary acidic protein [GFAP], plasma cellular fibronectin [c-Fn]), national institutes of health stroke scale (NIHSS) score and Barthel index of two groups were compared. Adverse reactions during treatment between the two groups were recorded. Results The levels of MMP-9, GFAP and c-Fn in the two groups on days 1 and 3 were higher than those before treatment, and the index levels on days 7 and 14 were lower than before treatment, while the time after treatment was longer, the index levels were lower, and the differences were statistically significant (P ＜ 0.05). The levels of MMP-9, GFAP, and c-Fn on the 3rd, 7th, and 14th days of treatment in the study group were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). In addition, the difference in the interaction of the indicators of the two groups was statistically significant (P ＜ 0.05). On the 14th day of treatment, the NIHSS score of the two groups were lower than before treatment, and the study group was lower than the control group; the Barthel index were higher than before treatment, and the study group was higher than the control group, the differences were statistically significant (P ＜ 0.05). The total incidence of HT in the study group was lower than that in the control group, and the difference was statistically significant (P ＜ 0.05). The incidence of adverse reactions between the two groups was not statistically significant (P > 0.05). Conclusion Edaravone can reduce the incidence of HT, improve the ability of self-care, reduce the damage of nerve function, and the safety of medication is better, which may be related to the down-regulation of MMP-9, GFAP, c-Fn and other factors.

Key words： Edaravone Acute cerebral infarction Recombinant tissue plasminogen activator intravenous thrombolysis Hemorrhagic transformation

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	XU Chunmei1 FAN Rong2 ZHANG Li3

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XU Chunmei1 FAN Rong2 ZHANG Li3. Effect of Edaravone in the hemorrhagic transformation after intravenous thrombolysis with rt-PA in patients with acute cerebral infarction[J]. 中国医药导报, 2020, 17(17): 79-83.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I17/79

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