谷红注射液联合阿替普酶对急性脑梗死患者血管内皮功能、纤溶系统等相关因子水平的影响
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摘要
目的:探讨联合应用谷红注射液和阿替普酶治疗对急性脑梗死患者血管内皮功能、纤溶系统等相关因子水平的影响。方法:选取本院诊治的急性脑梗死患者96例,随机分为对照组(48例)和观察组(48例)。对照组患者在常规对症治疗基础上应用阿替普酶,而观察组在对照组用药基础上加用谷红注射液。于治疗前后对两组患者的血清相关因子水平进行检测和比较。结果:治疗前,两组患者的血清相关指标内皮素-1(ET-1)、多胺氧化酶(PAO)、心型脂肪酸结合蛋白(H-FABP)、血管内皮生长因子(VEGF)、血清脑源性神经营养因子(S100β蛋白、BDNF)、循环内皮细胞(CEC)、扣针蛋白5(Fibulin-5)、管性血友病因子(vWF)、P-选择素(P-selectin)、组织型纤溶酶原激活物(t-PA)、快速抑制酶(PAI-1)水平之间差异无统计学意义(P>0.05);治疗后观察组患者的血清ET-1、PAO、H-FABP、S100β、CEC、Fibulin-5、vWF、P-selectin、PAI-1水平明显低于对照组,而血清VEGF、BDNF以及t-PA水平明显高于对照组,两组之间差异均具有统计学意义(P<0.05)。结论:对急性脑梗死患者在常规对症治疗以及阿替普酶用药的基础上加用谷红注射液,能够更加显著地改善患者血清相关因子水平,更有利于患者症状的控制和病情康复,疗效确切,值得临床上进一步研究应用。
Objective: To explore the effect of Guhong Injection combined with Atyplase on vascular endothelial function and fibrinolytic system and related factors in patients with acute cerebral infarction. Methods: To select 96 patients with acute cerebral infarction in our hospital, divided into control group(48 cases) and observation group(48 cases) randomly. Patients in the control group were treated with alteplase on the basis of routine symptomatic treatment, and the observation group was treated with Guhong injection on the basis of the control group. Before and after treatment, the serum levels of related factors were detected and compared between the two groups. Results: Before treatment, there were no significant differences in serum related factors(ET-1, PAO, H-FABP, VEGF, S100β, BDNF, CEC, Fibulin-5, vWF, P-selectin, t-PA, PAI-1) between the two groups(P>0.05); After treatment, the serum levels of ET-1, PAO, H-FABP, S100β, CEC, Fibulin-5, vWF, P-selectin, PAI-1 in the observation group were significantly lower than those in the control group, and the serum levels of VEGF, BDNF and t-PA were higher than those in the control group, there were significant differences between the two groups(P<0.05). Conclusion: Guhong injection was added to patients with acute cerebral infarction on the basis of routine symptomatic treatment and ateplase, could significantly improve the level of serum related factors, it was more conducive to the control of symptoms and rehabilitation of patients, the effect was definite, it was worth further study and application in clinic.
Objective: To explore the effect of Guhong Injection combined with Atyplase on vascular endothelial function and fibrinolytic system and related factors in patients with acute cerebral infarction. Methods: To select 96 patients with acute cerebral infarction in our hospital, divided into control group(48 cases) and observation group(48 cases) randomly. Patients in the control group were treated with alteplase on the basis of routine symptomatic treatment, and the observation group was treated with Guhong injection on the basis of the control group. Before and after treatment, the serum levels of related factors were detected and compared between the two groups. Results: Before treatment, there were no significant differences in serum related factors(ET-1, PAO, H-FABP, VEGF, S100β, BDNF, CEC, Fibulin-5, vWF, P-selectin, t-PA, PAI-1) between the two groups(P>0.05); After treatment, the serum levels of ET-1, PAO, H-FABP, S100β, CEC, Fibulin-5, vWF, P-selectin, PAI-1 in the observation group were significantly lower than those in the control group, and the serum levels of VEGF, BDNF and t-PA were higher than those in the control group, there were significant differences between the two groups(P<0.05). Conclusion: Guhong injection was added to patients with acute cerebral infarction on the basis of routine symptomatic treatment and ateplase, could significantly improve the level of serum related factors, it was more conducive to the control of symptoms and rehabilitation of patients, the effect was definite, it was worth further study and application in clinic.
引文
1 张玉蛟,刘新胜,白冰,等.进展性脑梗死预测因素与预后分析[J].中国实用神经疾病杂志,2018,21(5):535-538.
2 Pavlakis SG,Roach ES.Silent cerebral infarction:Not so silent after all[J].Neurology,2018,90(3):105-106.
3 Perera AH,Rudarakanchana N,Monzon L,et al.Cerebral embolization,silent cerebral infarction and neurocognitive decline after thoracic endovascular aortic repair[J].Br J Surg,2018,105(4):366-378.
4 中国中西医结合学会神经科专业委员会.中国脑梗死中西医结合诊治指南(2017)[J].中国中西医结合杂志,2018,38(2):136-144.
5 Tu J,Wang LX,Wen HF,et al.The association of different types of cerebral infarction with post-stroke depression and cognitive impairment[J].Medicine(Baltimore),2018,97(23):e10919.
6 Toida T,Sato Y,Nakagawa H,et al.Risk of cerebral infarction in Japanese hemodialysis patients:Miyazaki dialysis cohort study(MID study)[J].Kidney Blood Press Res,2016,41(4):471-478.
7 Li J,Meng XM,Li RY,et al.Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction[J].Neural Regeneration Res,2016,11(10):1584-1590.
8 王永超.舒血宁注射液联合阿替普酶静脉溶栓对急性脑梗死患者 NIHSS评分及生活质量的影响[J].北方药学,2019,16(1):55-56.
9 何晓玮,范晓萍,钟涛,等.谷红注射液治疗急性脑梗死总有效率和安全性的 meta分析[J].中华中医药学刊,2014,32(11):2602-2605.
10 Fang T,Guo B,Xue L,et al.Atorvastatin prevents myocardial fibrosis in spontaneous hypertension via interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (STAT3)/Endothelin-1 (ET-1) pathway[J].Med Sci Monit,2019,11(25):318-323.
11 Di Paolo ML,Cervelli M,Mariottini P,et al.Exploring the activity of polyamine analogues on polyamine and spermine oxidase:methoctramine,a potent and selective inhibitor of polyamine oxidase[J].J Enzyme Inhib Med Chem,2019,34(1):740-752.
12 刘伟,邵胜敏,李晟,等.阿托伐他汀钙对急性脑梗死患者血清ET-1、PAO、H-FABP、VEGF、S100β、炎症因子及神经功能的影响[J].中国生化药物杂志,2015,35(3):134-137.
13 Liu D,Tang ZY,Hu ZJ,et al.MiR-940 regulates angiogenesis after cerebral infarction through VEGF[J].Eur Rev Med Pharmacol Sci,2018,22(22):7899-7907.
14 江笑文.脑梗死患者血清NSE、S100β水平与认知功能的关系[J].中国医学创新,2019,16(7):43-46.
15 程超婵,潘君枝.阿替普酶治疗老年急性脑梗死的效果及对血清神经特异性烯醇化酶、S100β蛋白的影响[J].中国老年学杂志,2016,36(11):2632-2634.
16 Bagheri A,Talei S,Hassanzadeh N,et al.The neuroprotective effects of flaxseed oil supplementation on functional motor recovery in a model of ischemic brain stroke:Upregulation of BDNF and GDNF[J].Acta Med Iran,2017,55(12):785-792.
17 Liu L,Cui Y,Li X,et al.Concomitant overexpression of triple antioxidant enzymes selectively increases circulating endothelial progenitor cells in mice with limb ischaemia[J].J Cell Mol Med,2019,8(11):1-11.
18 徐红波.Fibulin-5、vWF 和 sCD14 在急性脑梗死检测中的意义[J].河北医药,2018,40(22):3378-3381.
19 Louw S,Wan YO,Mayne ES,et al.Analytical performance of a new immunoturbidimetric assay for von willebrand factor (VWF) activity testing[J].Clin Lab,2019,65(4):180919.
20 Wu S,Zhang X,Liu J,et al.Physicochemical characterization of Sargassum fusiforme fucoidan fractions and their antagonistic effect against P-selectin-mediated cell adhesion[J].Int J Biol Macromol,2019,29(19):30053-30054.
21 师仰宏,霍艳艳,黄苗,等.银杏达莫对急性脑梗死患者t-PA、Hcy、MMP-9的影响[J].现代生物医学进展,2017,17(20):3944-3947.
22 于海娜.血栓通与阿司匹林联合用药对急性脑梗死患者D-二聚体、血浆组织型纤溶酶原激活物、血栓调节蛋白、纤溶酶原激活物抑制物及神经功能的影响[J].中国药物经济学,2018,13(2):90-92.
2 Pavlakis SG,Roach ES.Silent cerebral infarction:Not so silent after all[J].Neurology,2018,90(3):105-106.
3 Perera AH,Rudarakanchana N,Monzon L,et al.Cerebral embolization,silent cerebral infarction and neurocognitive decline after thoracic endovascular aortic repair[J].Br J Surg,2018,105(4):366-378.
4 中国中西医结合学会神经科专业委员会.中国脑梗死中西医结合诊治指南(2017)[J].中国中西医结合杂志,2018,38(2):136-144.
5 Tu J,Wang LX,Wen HF,et al.The association of different types of cerebral infarction with post-stroke depression and cognitive impairment[J].Medicine(Baltimore),2018,97(23):e10919.
6 Toida T,Sato Y,Nakagawa H,et al.Risk of cerebral infarction in Japanese hemodialysis patients:Miyazaki dialysis cohort study(MID study)[J].Kidney Blood Press Res,2016,41(4):471-478.
7 Li J,Meng XM,Li RY,et al.Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction[J].Neural Regeneration Res,2016,11(10):1584-1590.
8 王永超.舒血宁注射液联合阿替普酶静脉溶栓对急性脑梗死患者 NIHSS评分及生活质量的影响[J].北方药学,2019,16(1):55-56.
9 何晓玮,范晓萍,钟涛,等.谷红注射液治疗急性脑梗死总有效率和安全性的 meta分析[J].中华中医药学刊,2014,32(11):2602-2605.
10 Fang T,Guo B,Xue L,et al.Atorvastatin prevents myocardial fibrosis in spontaneous hypertension via interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (STAT3)/Endothelin-1 (ET-1) pathway[J].Med Sci Monit,2019,11(25):318-323.
11 Di Paolo ML,Cervelli M,Mariottini P,et al.Exploring the activity of polyamine analogues on polyamine and spermine oxidase:methoctramine,a potent and selective inhibitor of polyamine oxidase[J].J Enzyme Inhib Med Chem,2019,34(1):740-752.
12 刘伟,邵胜敏,李晟,等.阿托伐他汀钙对急性脑梗死患者血清ET-1、PAO、H-FABP、VEGF、S100β、炎症因子及神经功能的影响[J].中国生化药物杂志,2015,35(3):134-137.
13 Liu D,Tang ZY,Hu ZJ,et al.MiR-940 regulates angiogenesis after cerebral infarction through VEGF[J].Eur Rev Med Pharmacol Sci,2018,22(22):7899-7907.
14 江笑文.脑梗死患者血清NSE、S100β水平与认知功能的关系[J].中国医学创新,2019,16(7):43-46.
15 程超婵,潘君枝.阿替普酶治疗老年急性脑梗死的效果及对血清神经特异性烯醇化酶、S100β蛋白的影响[J].中国老年学杂志,2016,36(11):2632-2634.
16 Bagheri A,Talei S,Hassanzadeh N,et al.The neuroprotective effects of flaxseed oil supplementation on functional motor recovery in a model of ischemic brain stroke:Upregulation of BDNF and GDNF[J].Acta Med Iran,2017,55(12):785-792.
17 Liu L,Cui Y,Li X,et al.Concomitant overexpression of triple antioxidant enzymes selectively increases circulating endothelial progenitor cells in mice with limb ischaemia[J].J Cell Mol Med,2019,8(11):1-11.
18 徐红波.Fibulin-5、vWF 和 sCD14 在急性脑梗死检测中的意义[J].河北医药,2018,40(22):3378-3381.
19 Louw S,Wan YO,Mayne ES,et al.Analytical performance of a new immunoturbidimetric assay for von willebrand factor (VWF) activity testing[J].Clin Lab,2019,65(4):180919.
20 Wu S,Zhang X,Liu J,et al.Physicochemical characterization of Sargassum fusiforme fucoidan fractions and their antagonistic effect against P-selectin-mediated cell adhesion[J].Int J Biol Macromol,2019,29(19):30053-30054.
21 师仰宏,霍艳艳,黄苗,等.银杏达莫对急性脑梗死患者t-PA、Hcy、MMP-9的影响[J].现代生物医学进展,2017,17(20):3944-3947.
22 于海娜.血栓通与阿司匹林联合用药对急性脑梗死患者D-二聚体、血浆组织型纤溶酶原激活物、血栓调节蛋白、纤溶酶原激活物抑制物及神经功能的影响[J].中国药物经济学,2018,13(2):90-92.