红花黄色素联合脑苷肌肽治疗对缺血性脑卒中患者神经功能的影响及机制研究
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摘要
目的:探讨红花黄色素联合脑苷肌肽治疗对缺血性脑卒中患者神经功能的影响,并分析其可能的机制。方法:选择2017年5月～2018年8月我院收治的缺血性脑卒中患者130例,依据随机数表法分为对照组和研究组各65例。对照组采用脑苷肌肽治疗,研究组在对照组的基础上应用红花黄色素治疗,比较两组患者治疗前后神经功能指标、氧化应激指标、血管内皮功能指标及炎症因子的变化。结果:两组患者治疗前神经功能指标、氧化应激指标、血管内皮功能指标及炎症因子比较,差异不显著(P>0.05)。治疗后,两组患者神经功能指标S-100β和NSE均显著降低,NGF水平显著升高,且研究组患者S-100β和NSE水平分别为(0.91±0.10)ng/L和(12.91±1.33)ng/L,显著低于对照组,NGF水平为(79.52±8.07)μg/L,显著高于对照组(P<0.05)。两组患者治疗后Ox-LDL水平显著降低,GSH-Px水平显著升高,且研究患者氧化应激指标Ox-LDL水平为(563.51±57.10)μg/dL,显著低于对照组,GSH-Px水平为(154.55±16.07)U/L,均显著高于对照组(P<0.05)。两组患者治疗后血管内皮功能指标NT-proBNP、TXB2及ET-1水平显著降低,研究组患者NT-proBNP、TXB2及ET-1分别为(95.91±9.77)pg/mL、(245.69±25.06)pg/mL及(64.26±6.65)ng/L,均显著低于对照组(P<0.05)。两组患者治疗后炎症因子MMP-9及TNF-α水平显著降低,且研究组患者MMP-9及TNF-α水平分别为(60.64±6.12)ng/mL及(0.33±0.04)ng/mL,均显著低于对照组(P<0.05)。结论:红花黄色素联合脑苷肌肽治疗缺血性脑卒中临床疗效较高,可显著改善患者的神经功能,其机制可能与改善血管内皮功能与应激反应有关。
Objective: To investigate the effects of safflower yellow pigment combined with cerebellin on neurological function in patients with ischemic stroke and analyze its possible mechanism. Methods:A total of 130 patients with ischemic stroke admitted to my hospital from May 2017 to August 2018 were enrolled. The patients were divided into the control group and the study group according to the random number table method, 65 cases in each group.The control group was treated with cerebroside carnosine.And the study group was treated with safflower yellow pigment on the basis of the control group. The changes of neurological function index, oxidative stress index, vascular endothelial function index and inflammatory factor were compared before and after treatment. Results:There were no significant differences in preoperative neurological parameters, oxidative stress, vascular endothelial function and inflammatory factors between the two groups(P>0.05). After treatment, the neurological function indexes S-100β and NSE were significantly lower in both groups, and NGF levels were significantly increased. The S-100β and NSE levels in the study group were(0.91±0.10) ng/L and(12.91±1.33) ng/L, respectively, which were significantly lower than control group. While the NGF level of the study group was(79.52±8.07) μg/L significantly higher than that of the control group(both P<0.05). The levels of Ox-LDL were significantly reduced and GSH-Px levels were significantly elevated in both groups after treatment.The level of oxidative stress index Ox-LDL was(563.51±57.10) μg/dL, which was significantly lower than that of the control group, and the GSH-Px level was(154.55±16.07) U/L, which was significantly higher than the control group(P<0.05). The levels of vascular endothelial function NT-proBNP, TXB2 and ET-1 were significantly lower in the two groups after treatment.The NT-proBNP, TXB2 and ET-1 in the study group were(95.91±9.77) pg/mL,(245.69±25.06) pg/mL and(64.26±6.65) ng/L, respectively, which were significantly lower than the control group(P<0.05). The levels of inflammatory factors MMP-9 and TNF-α were significantly lower in the two groups after treatment.The levels of MMP-9 and TNF-α in the study group were(60.64±6.12) ng/mL and(0.33±0.04) ng/mL, respectively, which were significantly lower than those in the control group(P<0.05). Conclusion:Safflor yellow combined with cerebellin in the treatment of ischemic stroke has higher clinical efficacy and can significantly improve the neurological function of patients. The possible mechanism is related to the improvement of vascular endothelial function and stress response.
Objective: To investigate the effects of safflower yellow pigment combined with cerebellin on neurological function in patients with ischemic stroke and analyze its possible mechanism. Methods:A total of 130 patients with ischemic stroke admitted to my hospital from May 2017 to August 2018 were enrolled. The patients were divided into the control group and the study group according to the random number table method, 65 cases in each group.The control group was treated with cerebroside carnosine.And the study group was treated with safflower yellow pigment on the basis of the control group. The changes of neurological function index, oxidative stress index, vascular endothelial function index and inflammatory factor were compared before and after treatment. Results:There were no significant differences in preoperative neurological parameters, oxidative stress, vascular endothelial function and inflammatory factors between the two groups(P>0.05). After treatment, the neurological function indexes S-100β and NSE were significantly lower in both groups, and NGF levels were significantly increased. The S-100β and NSE levels in the study group were(0.91±0.10) ng/L and(12.91±1.33) ng/L, respectively, which were significantly lower than control group. While the NGF level of the study group was(79.52±8.07) μg/L significantly higher than that of the control group(both P<0.05). The levels of Ox-LDL were significantly reduced and GSH-Px levels were significantly elevated in both groups after treatment.The level of oxidative stress index Ox-LDL was(563.51±57.10) μg/dL, which was significantly lower than that of the control group, and the GSH-Px level was(154.55±16.07) U/L, which was significantly higher than the control group(P<0.05). The levels of vascular endothelial function NT-proBNP, TXB2 and ET-1 were significantly lower in the two groups after treatment.The NT-proBNP, TXB2 and ET-1 in the study group were(95.91±9.77) pg/mL,(245.69±25.06) pg/mL and(64.26±6.65) ng/L, respectively, which were significantly lower than the control group(P<0.05). The levels of inflammatory factors MMP-9 and TNF-α were significantly lower in the two groups after treatment.The levels of MMP-9 and TNF-α in the study group were(60.64±6.12) ng/mL and(0.33±0.04) ng/mL, respectively, which were significantly lower than those in the control group(P<0.05). Conclusion:Safflor yellow combined with cerebellin in the treatment of ischemic stroke has higher clinical efficacy and can significantly improve the neurological function of patients. The possible mechanism is related to the improvement of vascular endothelial function and stress response.
引文
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2 Zhang YH,Ma ZW,Wang HR.Clinical observation of butylphthalide combined with tanshinone injection in the treatment of acute cerebral infarction[J].J Pract Geriat,2017,31(11):1082-1083.
3 Turc G,Maer B,Naggara O,et al.Clinical Scales Do Not Reliably Identify Acute Ischemic Stroke Patients With LargeArtery Occlusion[J].Stroke,2016,47(6):1466-1472.
4 Yaghi S,Willey JZ,Cucchiara B,et al.Treatment and outcome of hemorrhagic transformation after intravenous alteplase in acute ischemic stroke:a scientific statement for healthcare professionals from the american heart association/american stroke association[J].Stroke,2017,48(12):e343.
5 Zhang N,Sun HN,Wang P,et al.Clinical observation of cerebroside carnosine combined with safflower yellow in the treatment of acute cerebral infarction[J].J Integr Tradit Western Med Cardiov Cerebrov Dis,2014,12(5):574-575.
6 Liu Y,Tian X,Cui M,et al.Safflower yellow inhibits angiotensin II-induced adventitial fibroblast proliferation and migration.[J].J Pharmacol Sci,2014,126(2):107.
7 Fan S,Lin N,Shan G,et al.Safflower yellow for acute ischemic stroke:a systematic review of randomized controlled trials[J].Compl Ther Med,2014,22(2):354-361.
8 Rao MQ.Abstract of"Guidelines for Prevention and Treatment of Cerebrovascular Diseases in China"(Ⅱ)[J].J Apopl Nerv Dis,2005,23(2):8-12.
9 Touma L,Filion KB,Sterling LH,et al.Stent retrievers for the treatment of acute ischemic stroke:a systematic review and meta-analysis of randomized clinical trials[J].Jama Neurol,2016,73(3):275.
10 Goyal M,Jadhav AP,Bonafe A,et al.Analysis of workflow and time to treatment and the effects on outcome in endovascular treatment of acute ischemic stroke:results from the SWIFTPRIME randomized controlled trial[J].Radiol,2016,279(3):160204.
11 Wei D,Yang YF,Li GP.Clinical study of Ginkgo biloba extract injection combined with cerebroside carnosine in the treatment of acute cerebral infarction[J].Modern Med Clin Med,2018,33(2):247-250.
12 Xiong XD.Clinical observation of safflower yellow pigment injection in the treatment of diabetic patients with acute cerebral infarction[J].J Liaoning Univ Tradit Chinese Med,2018,20(3):157-159.
13 Shi Q,Fan T,Yang JB.Meta-analysis of the effect of safflower yellow pigment on hemorheology in patients with acute cerebral infarction[J].Shanghai J Tradit Chinese Med,2016,50(9):18-22.
14 Zhu ZH,Huang XF,Wang Y,et al.Effects of Danhong injection and hydroxysafflor yellow A on the expression of IL-1β,TNF-αand caspase-3 mRNA after cerebral ischemia-reperfusion in rats[J]Chinese J Tradit Chinese Med,2016,31(4):1390-1393.
15 Lu K,Xu X,Cui S,et al.Serum neuron specific enolase level as a predictor of prognosis in acute ischemic stroke patients after intravenous thrombolysis[J].JNeurol Sci,2015,359(1-2):202-206.
16 Byun YS,Yang X,Bao W,et al.Oxidized phospholipids on apolipoprotein b-100and recurrent ischemic events following stroke or transient ischemic attack.[J].J Am Coll Cardiol,2017,69(2):147.
17 Yang H.Clinical study of safflower yellow pigment combined with edaravone in the treatment of cerebral infarction[J].Lishizhen Med Mater Med Res,2014,25(10):2451-2453.
18 Byun YS,Yang X,Bao W,et al.Oxidized phospholipids on apolipoprotein B-100and recurrent ischemic events following stroke or transient ischemic attack.[J].J Am Coll Cardiol,2017,69(2):147.
19 Zhou J,Li XY,Han Y.Effects of safflower yellow pigment combined with low molecular weight heparin calcium on oxidative stress and neurological function in patients with acute cerebral infarction[J].China Pharmaceut,2018,27(2):60-62.
20 Wildi KS,Nigro N,Mueller C,et al.BNP but not Troponin is associated with cardioembolic aetiology and poor outcome after acute ischemic stroke or TIA[J].Eur Heart J,2013,34(suppl 1):P405-P405.
21 Ji Z,Fan XB.Clinical study of safflower yellow pigment combined with argatroban for acute cerebral infarction[J].Modern Med Clin,2016,31(2):158-162.
22 Wang L,Li Z,Zhang X,et al.Protective effect of shikonin in experimental ischemic stroke:attenuated TLR4,p-p38MAPK,NF-κB,TNF-αand MMP-9expression,up-regulated claudin-5expression,ameliorated BBB permeability.[J].Neurochem Res,2014,39(1):97-106.
2 Zhang YH,Ma ZW,Wang HR.Clinical observation of butylphthalide combined with tanshinone injection in the treatment of acute cerebral infarction[J].J Pract Geriat,2017,31(11):1082-1083.
3 Turc G,Maer B,Naggara O,et al.Clinical Scales Do Not Reliably Identify Acute Ischemic Stroke Patients With LargeArtery Occlusion[J].Stroke,2016,47(6):1466-1472.
4 Yaghi S,Willey JZ,Cucchiara B,et al.Treatment and outcome of hemorrhagic transformation after intravenous alteplase in acute ischemic stroke:a scientific statement for healthcare professionals from the american heart association/american stroke association[J].Stroke,2017,48(12):e343.
5 Zhang N,Sun HN,Wang P,et al.Clinical observation of cerebroside carnosine combined with safflower yellow in the treatment of acute cerebral infarction[J].J Integr Tradit Western Med Cardiov Cerebrov Dis,2014,12(5):574-575.
6 Liu Y,Tian X,Cui M,et al.Safflower yellow inhibits angiotensin II-induced adventitial fibroblast proliferation and migration.[J].J Pharmacol Sci,2014,126(2):107.
7 Fan S,Lin N,Shan G,et al.Safflower yellow for acute ischemic stroke:a systematic review of randomized controlled trials[J].Compl Ther Med,2014,22(2):354-361.
8 Rao MQ.Abstract of"Guidelines for Prevention and Treatment of Cerebrovascular Diseases in China"(Ⅱ)[J].J Apopl Nerv Dis,2005,23(2):8-12.
9 Touma L,Filion KB,Sterling LH,et al.Stent retrievers for the treatment of acute ischemic stroke:a systematic review and meta-analysis of randomized clinical trials[J].Jama Neurol,2016,73(3):275.
10 Goyal M,Jadhav AP,Bonafe A,et al.Analysis of workflow and time to treatment and the effects on outcome in endovascular treatment of acute ischemic stroke:results from the SWIFTPRIME randomized controlled trial[J].Radiol,2016,279(3):160204.
11 Wei D,Yang YF,Li GP.Clinical study of Ginkgo biloba extract injection combined with cerebroside carnosine in the treatment of acute cerebral infarction[J].Modern Med Clin Med,2018,33(2):247-250.
12 Xiong XD.Clinical observation of safflower yellow pigment injection in the treatment of diabetic patients with acute cerebral infarction[J].J Liaoning Univ Tradit Chinese Med,2018,20(3):157-159.
13 Shi Q,Fan T,Yang JB.Meta-analysis of the effect of safflower yellow pigment on hemorheology in patients with acute cerebral infarction[J].Shanghai J Tradit Chinese Med,2016,50(9):18-22.
14 Zhu ZH,Huang XF,Wang Y,et al.Effects of Danhong injection and hydroxysafflor yellow A on the expression of IL-1β,TNF-αand caspase-3 mRNA after cerebral ischemia-reperfusion in rats[J]Chinese J Tradit Chinese Med,2016,31(4):1390-1393.
15 Lu K,Xu X,Cui S,et al.Serum neuron specific enolase level as a predictor of prognosis in acute ischemic stroke patients after intravenous thrombolysis[J].JNeurol Sci,2015,359(1-2):202-206.
16 Byun YS,Yang X,Bao W,et al.Oxidized phospholipids on apolipoprotein b-100and recurrent ischemic events following stroke or transient ischemic attack.[J].J Am Coll Cardiol,2017,69(2):147.
17 Yang H.Clinical study of safflower yellow pigment combined with edaravone in the treatment of cerebral infarction[J].Lishizhen Med Mater Med Res,2014,25(10):2451-2453.
18 Byun YS,Yang X,Bao W,et al.Oxidized phospholipids on apolipoprotein B-100and recurrent ischemic events following stroke or transient ischemic attack.[J].J Am Coll Cardiol,2017,69(2):147.
19 Zhou J,Li XY,Han Y.Effects of safflower yellow pigment combined with low molecular weight heparin calcium on oxidative stress and neurological function in patients with acute cerebral infarction[J].China Pharmaceut,2018,27(2):60-62.
20 Wildi KS,Nigro N,Mueller C,et al.BNP but not Troponin is associated with cardioembolic aetiology and poor outcome after acute ischemic stroke or TIA[J].Eur Heart J,2013,34(suppl 1):P405-P405.
21 Ji Z,Fan XB.Clinical study of safflower yellow pigment combined with argatroban for acute cerebral infarction[J].Modern Med Clin,2016,31(2):158-162.
22 Wang L,Li Z,Zhang X,et al.Protective effect of shikonin in experimental ischemic stroke:attenuated TLR4,p-p38MAPK,NF-κB,TNF-αand MMP-9expression,up-regulated claudin-5expression,ameliorated BBB permeability.[J].Neurochem Res,2014,39(1):97-106.
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