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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

37

期数:

2020年3

页码:

266-269

栏目:

临床研究

出版日期:

2020-03-12

文章信息/Info

Title:

Effect of edaravone on cognitive function of patients with intracranial aneurysm after endovascular embolization

作者:

邢俊领¹; 张永森¹; 吕林亚¹; 张鹏¹; 高国军²

（1.新乡医学院第三附属医院神经外科，河南　新乡　453003；2.新乡医学院第一附属医院神经外科，河南　卫辉　453100）

Author(s):

XING Junling¹; ZHANG Yongsen¹; LYU Linya¹; ZHANG Peng¹; GAO Guojun²

(1.Department of Neurosurgery,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China; 2.Department of Neurosurgery,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

关键词:

颅内动脉瘤; 血管内栓塞术; 依达拉奉; 认知功能

Keywords:

intracranial aneurysm;  endovascular embolization;  edaravone;  cognitive function

分类号:

R651.1

DOI:

10.7683/xxyxyxb.2020.03.016

文献标志码:

A

摘要:

目的　探讨血管内栓塞术后应用依达拉奉对颅内动脉瘤（ICA）患者认知功能的影响。方法　选择2014年1月至2018年1月新乡医学院第三附属医院收治的144例ICA患者为研究对象，根据治疗方法分为观察组和对照组，每组72例。2组患者均行血管内栓塞术，观察组患者在血管内栓塞术后给予依达拉奉注射液治疗2周，对照组患者血管内栓塞术后不应用依达拉奉注射液治疗。术前及术后2周，采用精神状态简易速检表（MMSE）评估患者认知功能，并检测血清丙二醛（MDA）、超氧化物歧化酶（SOD）、白细胞介素-18（IL-18）、肿瘤坏死因子-α（TNF-α）水平；术后观察2组患者并发症发生情况。结果　2组患者术前MMSE评分比较差异无统计学意义（P＞0.05）；对照组患者术后2周MMSE量表各项目评分及总评分均低于术前（P<0.05），观察组患者术后2周MMSE量表中记忆力评分及总评分低于术前（P<0.05）；术后2周，观察组患者MMSE量表各项目评分及总评分均高于对照组（P<0.05）。观察组和对照组患者术后认知功能障碍发生率分别为26.39%（19/72）、43.06%（31/72），观察组患者术后认知功能障碍发生率低于对照组（χ²=4.412，P<0.05）。2组患者术前血清MDA、SOD水平比较差异无统计学意义（P＞0.05）；2组患者术后2周血清MDA水平高于术前，SOD水平低于术前（P<0.05）；术后2周，观察组患者血清MDA水平低于对照组，SOD水平高于对照组（P<0.05）。2组患者术前血清IL-18、TNF-α水平比较差异无统计学意义（P＞0.05）；对照组患者术后2周血清IL-18、TNF-α水平高于术前（P<0.05），观察组患者术后2周与术前血清IL-18、TNF-α水平比较差异无统计学意义（P＞0.05）；术后2周，观察组患者血清IL-18、TNF-α水平低于对照组（P<0.05）。观察组和对照组患者术后并发症发生率分别为4.16%（3/72）、15.28%（11/72），观察组患者术后并发症发生率低于对照组（χ²=5.064，P<0.05）。结论　ICA患者行血管内栓塞术后应用依达拉奉可以有效清除机体氧自由基，调节血清相关炎症因子水平，改善患者认知功能，降低认知功能障碍和并发症发生率。

Abstract:

Objective　To investigate the effect of edaravone on cognitive function of patients with intracranial aneurysm (ICA) after endovascular embolization.Methods　A total of 144 patients with ICA admitted to the Third Affiliated Hospital of Xinxiang Medical University from January 2014 to January 2018 were selected as the subjects.The patients were divided into observation group and control group according to the treatment methods,with 72 cases in each group.The patients in the two groups underwent intravascular embolization,and the patients in the observation group were treated with edaravone injection for two weeks after intravascular embolization,but the patients in the control group were not treated with edaravone injection after intravascular embolization.Before and two weeks after operation,the cognitive function of patients was evaluated by mini-mental state examination(MMSE),and the levels of serum malondialdehyde(MDA),superoxide dismutase(SOD),interleukin-18(IL-18) and tumor necrosis factor-α(TNF-α) were detected.The postoperative complications of patients in the two groups were observed.Results　There were no significant difference in MMSE scores between the two groups before operation (P>0.05).The scores of each item and the total score of MMSE at two weeks after operation were lower than those before operation in the control group (P<0.05).The memory score and total score of MMSE at two weeks after operation were lower than those before operation in the observation group (P<0.05).The scores of each item and the total score of MMSE in the observation group were higher than those in the control group at two weeks after operation (P<0.05).The incidence of postoperative cognitive dysfunction in the observation group and the control group was 26.39% (19/72) and 43.06% (31/72),respectively.The incidence of postoperative cognitive dysfunction in the observation group was lower than that in the control group (χ²=4.412,P<0.05).There was no significant difference in the levels of serum MDA and SOD between the two groups (P>0.05).The serum MDA level at two weeks after operation was higher than that before operation,and the serum SOD level at two weeks after operation was lower than that before operation in the two groups (P<0.05).At two weeks after operation,the serum MDA level in the observation group was lower than that in the control group,and the serum SOD level in the observation group was higher than that in the control group (P<0.05).There was no significant difference in the levels of serum IL-18 and TNF-α between the two groups (P>0.05).The levels of serum IL-18 and TNF-α at two weeks after operation were higher than those before operation in the control group (P<0.05).There was no significant difference in the levels of serum IL-18 and TNF-α at two weeks after operation and before operation in the observation group (P>0.05).The levels of serum IL-18 and TNF-α in the observation group were lower than those in the control group at two weeks after operation (P<0.05).The incidence of postoperative complications in the observation group and the control group was 4.16% (3/72) and 15.28% (11/72),respectively.The incidence of postoperative complications in the observation group was lower than that in the control group (χ²=5.064,P<0.05).Conclusions　Edaravone can effectively eliminate oxygen radicals,regulate the level of serum inflammatory factors,improve the cognitive function,and reduce the incidence of cognitive dysfunction and complications in ICA patients after endovascular embolization.

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更新日期/Last Update: 2020-03-05