Edaravone before intravenous thrombolysis with alteplase for patients with acute cerebral infarction: Efficacy and impact on transformation of cerebral hemorrhage

doi:10.3877/cma.j.issn.1674-0785.2021.12.003

Abstract

Abstract:

Objective

To investigate the efficacy of edaravone before intravenous thrombolysis with alteplase in patients with acute cerebral infarction and the impact on the transformation of cerebral hemorrhage.

Methods

A total of 100 patients with acute cerebral infarction at Chongzhou People's Hospital from February 2018 to October 2019 were collected, and they were randomly divided into an observation group and a control group, with 50 cases in each group. The observation group was treated with alteplase combined with edaravone before thrombolysis, and the control group was treated with alteplase alone. Both groups continued to be treated with edaravone after thrombolysis. We compared National Institutes of Health Stroke Scale (NIHSS) scores before thrombolysis, immediately after thrombolysis, 24 hours after thrombolysis, and 7 days after thrombolysis; plasma D-dimer and high sensitive C-reactive protein (hs-CRP) levels; and the expression of miRNA-24 and miRNA-223 in peripheral blood before and 24 hours after thrombolysis; modified Rankin scale (mRS) scores at 10 and 90 days after thrombolysis; and the transformation rate of cerebral hemorrhage 24 h after thrombolysis between the two groups.

Results

The NIHSS scores immediately, 24 h, and 7 days after thrombolysis were significantly lower than those before thrombolysis in both groups (P＜0.05 each); the NIHSS scores of the observation group immediately, 24 h, and 7 days after thrombolysis were significantly lower than those of the control group (P＜0.05 each). The plasma D-dimer and hs-CRP level at 24 h after thrombolysis were significantly lower than those before thrombolysis in both groups (P＜0.05); the plasma D-dimer and hs-CRP levels at 24 h after thrombolysis were significantly lower than those of the control group (P＜0.05). The expression of miRNA-24 in peripheral blood at 24 h after thrombolysis was increased in both groups, while the expression of miRNA-223 was decreased; the changes in the expression of miRNA-24 and miRNA-223 in peripheral blood were more significant in the observation group than in the control group (P＜0.05). The mRS scores at 10 and 90 days after thrombolysis were significantly lower in the observation group than in the control group (P＜0.05). There was no significant difference in intracerebral hemorrhage transformation of the two groups at 24 h after thrombolysis (P＞0.05).

Conclusion

Edaravone before intravenous thrombolysis of alteplase has good efficacy in patients with acute cerebral infarction, and can reduce the transformation of cerebral hemorrhage, up-regulate the expression of miRNA-24, and down-regulate the expression of miRNA-223.

Key words: Alteplase, Intravenous thrombolysis, Edaravone, Acute cerebral infarction, Curative effect, Transformation of cerebral hemorrhage

Youlin Wu, Xiurong Zhu, Shifu Liang, Wenbin Wu. Edaravone before intravenous thrombolysis with alteplase for patients with acute cerebral infarction: Efficacy and impact on transformation of cerebral hemorrhage[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(12): 928-932.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2021.12.003

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Figures/Tables 5

References 22

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组别	例数	溶栓前	溶栓后即刻	溶栓后24 h	溶栓后7天
观察组	50	10.13±0.78	7.02±1.56^a	5.73±1.23^a	4.85±0.82^a
对照组	50	10.04±1.09	8.76±1.89^a	7.65±1.37^a	5.91±1.17^a
t值		0.475	5.021	7.374	5.246
P值		0.636	＜0.001	＜0.001	＜0.001

组别	例数	溶栓前	溶栓后即刻	溶栓后24 h	溶栓后7天
观察组	50	10.13±0.78	7.02±1.56^a	5.73±1.23^a	4.85±0.82^a
对照组	50	10.04±1.09	8.76±1.89^a	7.65±1.37^a	5.91±1.17^a
t值		0.475	5.021	7.374	5.246
P值		0.636	＜0.001	＜0.001	＜0.001

组别	例数	D-二聚体（μg/ml）		hs-CRP（mg/L）
组别	例数	溶栓前	溶栓后24 h	溶栓前	溶栓后24 h
观察组	50	0.89±0.15	0.35±0.08^a	7.18±0.65	2.68±0.46^a
对照组	50	0.92±0.16	0.62±0.12^a	7.23±0.83	3.97±0.54^a
t值		0.967	13.238	0.335	12.859
P值		0.336	＜0.001	0.738	＜0.001

组别	例数	D-二聚体（μg/ml）		hs-CRP（mg/L）
组别	例数	溶栓前	溶栓后24 h	溶栓前	溶栓后24 h
观察组	50	0.89±0.15	0.35±0.08^a	7.18±0.65	2.68±0.46^a
对照组	50	0.92±0.16	0.62±0.12^a	7.23±0.83	3.97±0.54^a
t值		0.967	13.238	0.335	12.859
P值		0.336	＜0.001	0.738	＜0.001

组别	例数	miRNA-24相对表达量		miRNA-223相对表达量
组别	例数	溶栓前	溶栓后24 h	溶栓前	溶栓后24 h
观察组	50	0.73±0.19	1.48±0.27^a	1.85±0.16	1.09±0.15^a
对照组	50	0.70±0.26	1.05±0.23^a	1.86±0.19	1.43±0.13^a
t值		0.659	8.573	0.285	12.112
P值		0.512	＜0.001	0.777	＜0.001

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