摘要
目的分析联合心脑宁胶囊对脑梗死恢复期患者高迁移率族蛋白B1(HMGB1)/Toll样受体4(TLR4)/核因子-κB(NF-κB)通路及脑中动脉血流的影响。方法选取2019年1月至2023年10月收治的脑梗死恢复期患者82例,采用抽签法分组,将采用依达拉奉治疗患者设为依达拉奉组,采用依达拉奉联合心脑宁胶囊治疗患者设为联合心脑宁组,每组41例,均治疗2周。统计2组治疗2周后的临床疗效及治疗期间不良反应发生情况,比较2组治疗前和治疗2周后血清HMGB1/TLR4/NF-κB通路指标水平、神经损伤指标水平、脑中动脉血流参数及神经功能、认知功能、生活能力。结果治疗2周后,联合心脑宁组总有效率为92.68%高于依达拉奉组的73.17%(P<0.05)。治疗2周后2组血清HMGB1、TLR4、NF-κB水平降低,且联合心脑宁组低于依达拉奉组(P<0.05,P<001)。治疗2周后2组血清神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)、神经营养因子-3(NT-3)水平降低,脑源性神经营养因子(BDNF)水平升高,且联合心脑宁组血清NSE、S100β、NT-3降低及BDNF升高程度均大于依达拉奉组(P<0.05,P<001)。治疗2周后2组脑中动脉平均流速(Vm)升高,脑中动脉阻力指数(RI)、搏动指数(PI)降低,且联合心脑宁组脑中动脉Vm升高及RI、PI降低程度均大于依达拉奉组(P<0.05,P<001)。治疗2周后2组美国国立卫生研究院卒中量表(NIHSS)评分降低,蒙特利尔认知评估量表(MoCA)、改良Barthel指数(MBI)评分升高,且联合心脑宁组NIHSS评分降低及MoCA、MBI评分升高程度均大于依达拉奉组(P<0.05,P<001)。治疗期间,2组总不良反应发生率比较差异无统计学意义(P>0.05)。结论心脑宁胶囊联合依达拉奉治疗可有效调节脑梗死恢复期患者HMGB1/TLR4/NF-κB通路因子表达水平,缓解患者神经损伤,改善脑中动脉血流情况,提高患者神经功能、认知功能、生活能力,具有较好的临床疗效,且安全性良好。
Objective To analyze the effects of combined Xinnaoning capsule on high mobility group protein B1(HMGB1)/Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)pathway and middle cerebral artery blood flow in pa-tients with convalescent cerebral infarction.Methods A total of 82 patients with convalescent cerebral infarction admitted from January 2019 to October 2023 were selected.Using the lottery method,patients treated with Edaravone were assigned to Edaravone group,and the patients treated with Edaravone combined with Xinnaoning capsule were assigned to combined Xinn-aoning group,with 41 cases in each group.Both groups were treated for 2 weeks.The clinical efficacy of the two groups at 2 weeks after treatment and the occurrence of adverse reactions during treatment were analyzed.Serum HMGB1/TLR4/NF-κB pathway index level,nerve injury index level,cerebral middle artery-related blood flow parameters,nerve function,cognitive function and life ability of the two groups were compared before and at 2 weeks after treatment.Results At 2 weeks after treatment,the total effective rate of combined Xinnaoning group was 92.68%,which was higher than that of Edaravone group(73.17%)(P<0.05).At 2 weeks after treatment,serum levels of HMGB1,TLR4 and NF-κB in the two groups were de-creased,which were lower in combined Xinnaoning group than in Edaravone group(P<0.05,P<0.01).At 2 weeks after treatment,the serum levels of neuron-specific enolase(NSE),central nervous system specific proteinβ(S100β)and neuro-trophic factor-3(NT-3)in the two groups were decreased,while the levels of brain-derived neurotrophic factor(BDNF)were increased.The decrease in the levels of serum NSE,S100βand NT-3 and the increase in BDNF in the combined Xinnaning group were greater than those in Edaravone group(P<0.05,P<0.01).At 2 weeks after treatment,the mean flow velocity(Vm)of cerebral artery was increased in the two groups,and the cerebral artery resistance index(RI)and pulse index(PI)were decreased,and the increase of cerebral artery Vm and the decre
作者
王健
席培林
WANG Jian;XI Peilin(Department of Pharmacy,Ulanqab Central Hospital,Ulanqab,Inner Mongolia Autonomous Region 012000,China;Department of Neurology,Ulanqab Central Hospital,Ulanqab,Inner Mongolia Autonomous Region 012000,China)
出处
《临床误诊误治》
CAS
2024年第14期79-83,共5页
Clinical Misdiagnosis & Mistherapy
基金
国家卫生健康委“十四五”规划重点课题(YYWS9439)。
关键词
脑梗死
恢复期
心脑宁胶囊
依达拉奉
高迁移率族蛋白B1
Toll样受体4
核因子-κB
脑中动脉
Cerebral infarction
Convalescence period
Xinnaoning capsule
Edaravone
High mobility group protein B1
Toll-like receptor 4
Nuclear factor-κB
Middle cerebral artery
