新疆医科大学学报

目的 探讨依达拉奉右莰醇、阿加曲班辅以高压氧治疗急性脑梗死(Acute cerebral infarction, ACI)的临床疗效。方法 将2022年1月至2024年3月收治的120例脑梗死患者随机分为治疗1组(40例)、治疗2组(40例)和对照组(40例)。对照组进行常规治疗；治疗1组在常规治疗基础上采用依达拉奉右莰醇联合阿加曲班治疗；治疗2组在治疗组1基础上联合高压氧治疗。所有患者均治疗14 d。比较3组疗效、凝血功能指标[纤维蛋白原(Fibrinogen, FIB)、凝血酶原时间(Prothrombin time, PT)、D-二聚体(D-Dimer, D-D)]、炎症指标[白细胞介素6(Interleukin-6,IL-6)]、氧化应激指标[丙二醛(Malondialdehyde, MDA)、超氧化物歧化酶(Superoxide dismutase, SOD)]、神经功能[美国国立卫生研究院卒中量表(National institute of health stroke scale, NIHSS)评分、改良Rankin量表(Modified rankin scale, mRS)评分]、不良反应发生率。结果 治疗2组治疗有效率为95.00%,均高于治疗1组(85.00%)及对照组(75.00%),差异有统计学意义(P<0.05)。治疗后，治疗1组和治疗2组的PT、SOD均高于对照组，而FIB、D-D、MDA、IL-6、NIHSS和mRS评分均低于对照组(P<0.05),且治疗2组的PT、SOD高于治疗1组，FIB、D-D、MDA、IL-6、NIHSS和mRS评分均低于治疗1组，差异均有统计学意义(P<0.05)。结论 依达拉奉右莰醇、阿加曲班辅以高压氧治疗ACI的效果优于单纯药物治疗，并且可以明显改善患者神经功能、凝血功能、炎症及氧化应激损伤。

Objective To observation the mechanism of action of edaravone dextrocamphorol and agattriban combined with hyperbaric oxygen in the therapeutic effect of acute cerebral infarction(ACI). Methods 120 patients with cerebral infarction were admitted in the hospital from January 2022 to March 2024 were randomly divided into treatment group 1(40 cases), treatment group 2(40 cases) and control group(40 cases). The control group received routine treatment; treatment group 1 was treated with edaravone and dexmedetomidine in combination with argatroban on the basis of conventional treatment; treatment group 2 received hyperbaric oxygen therapy in addition to treatment group 1. All patients were treated for 14 days. Compared the efficacy, coagulation function indicators [fibrinogen(FIB), prothrombin time(PT), D-dimer(D-D)], inflammation indicators [interleukin-6(IL-6)], oxidative stress indicators [malondialdehyde(MDA), superoxide dismutase(SOD)], neurological function [National Institute of Health Stroke Scale(NIHSS) score, modified Rankin Scale(mRS) score], and incidence of adverse reactions among the 3 groups. Results The effective rate of treatment was 95.00% in the treatment group 2, which was higher than that in the treatment group 1(85.00%) and the control group(75.00%)(P<0.05). After the treatment, PT and SOD in the treatment groups 1 and 2 were higher than those in the control group, while FIB, D-D, MDA, IL-6, NIHSS and mRS scores were lower than in the control group(P<0.05), and PT and SOD in the treatment group 2 were higher than those in the treatment group 1, FIB, D-D, MDA, IL-6, NIHSS and mRS scores were lower than those in the treatment group 1, with significant differences(P<0.05). Conclusion The combination of edaravone and argatroban with hyperbaric oxygen therapy is more effective in treating ACI than drug therapy alone, and can significantly improve patients′ neurological function, coagulation function, inflammation and oxidative stress damage.