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目的观察依达拉奉对脑梗死患者的疗效,及对血清高迁移率族蛋白盒1(HMGB1)和基质金属蛋白酶9(MMP-9)水平的影响。方法采用随机、对照、单盲的前瞻性研究。120例急性脑梗死患者按照随机数字表法分为对照组和依达拉奉组(均n=60)。两组均采用常规治疗,依达拉奉组加用依达拉奉30 mg,bid,对照组给予等容量氯化钠注射液,疗程为14 d,另设正常对照组(n=130)。于治疗前,治疗后3、7、14 d检测血清HMGB1、MMP-9水平和斯堪的纳维亚神经卒中量表(SSS)评分、日常生活能力(ADL)评分和美国国立卫生院卒中量表(NIHSS)评分评定神经功能缺损。结果治疗后7、14 d,依达拉奉组血清HMGB1和MMP-9含量均明显低于对照组(均P<0.01)。治疗后14、21 d,依达拉奉组患者SSS和ADL评分均高于对照组(均P<0.01),NIHSS评分低于对照组(均P<0.01)。脑梗死患者血清MMP-9、HMGB1水平与SSS、ADL评分呈负相关,与NIHSS评分呈正相关,且血清MMP-9与血清HMGB1水平呈显著正相关(均P<0.01)。结论患者血清的MMP-9和HMGB1浓度与神经功能损伤程度呈正相关,依达拉奉治疗可有效降低血清MMP-9和HMGB1水平,具有改善患者神经功能的作用。
Objective To observe the curative effect of edaravone on patients with cerebral infarction and its effect on serum high mobility group box 1 (HMGB1) and matrix metalloproteinase 9 (MMP-9) levels. Methods Randomized, controlled, single-blind, prospective study. 120 patients with acute cerebral infarction were divided into control group and edaravone group according to random number table (n = 60). Both groups were treated with edaravone plus edaravone 30 mg twice a day. The control group was given the same volume of sodium chloride injection for 14 days. A normal control group (n = 130) was also established. Serum HMGB1 and MMP-9 levels, Scandinavian Nerve Stroke Scale (SSS) score, ADL score and National Institutes of Health Stroke Scale were measured before treatment and 3, 7 and 14 days after treatment. Table (NIHSS) score to assess neurological deficit. Results At 7 and 14 days after treatment, the levels of serum HMGB1 and MMP-9 in edaravone group were significantly lower than those in control group (all P <0.01). The scores of SSS and ADL in edaravone group were higher than those in control group (all P <0.01) at 14 and 21 d after treatment, and NIHSS scores were lower than those in control group (all P <0.01). Serum levels of MMP-9 and HMGB1 in patients with cerebral infarction were negatively correlated with SSS and ADL scores, positively correlated with NIHSS score, and positively correlated with serum HMGB1 levels (all P <0.01). Conclusions Serum levels of MMP-9 and HMGB1 are positively correlated with the severity of neurological impairment. Edaravone can effectively reduce the levels of serum MMP-9 and HMGB1 and improve the neurological function.