摘要
Abstract
Objective:To study the effect of panax notoginseng saponins (PNS) on ischemia reperfusion injury and hemorrhagic transformation (HT) after recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis in patients with acute cerebral infarction.Methods:We conducted retrospective analysis on 131 patients with early acute cerebral infarction (the time of disease attack to reception no less than 4.5 h),including the PNS group with 66 cases and the control group with 65 cases.The control group was treated with rt-PA + routine treatment,on the basis of the control group treatment,the PNS group was treated with PNS injections 400 mg + 5％ glucose injection,intravenous drip,once a day.Two groups were treated for 15 days,and we investigated the clinic effective of two treatment after 24 h and 15 d.The ischemia reperfusion injury index superoxide dismutase (SOD),malondialdehyde (MDA),and the hemorrhagic transformation prediction index matrix metalloproteinase 9 (MMP-9),fibronectin (c-Fn) were test by regent kit according Operation instructions for blood sample of patients.The HT was test by computerized tomographic scanning,and stroke scale (NIHSS) and index Barthel were used to evaluate the nerve function.Results:Compared with thrombolysis before,at post-thrombolysis 24 h,the result of MDA,MMP-9,c-Fn and Barthel index in the two groups were significantly increased,the scores of SOD and NIHSS were significantly decreased,and the clinical index of the PNS group was significantly improved compared with the control group (t=2.54,2.50,2.52,2.55,2.55,2.57,all P＜0.05).Clinical indicators (MDA,SOD,MMP-9,c-Fn,NIHSS score and Barthel index) improved compared with before treatment in patients of two groups (all P＜0.01),and the PNS group improved more significantly than the control group (t=4.61,4.98,4.4589,4.68,4.38,5.87,all P＜0.01).The result of CT showed that Hemorrhagic transformation rate of the PNS group was lower than those of the control group within 15 days of treatment (x2=4.15,P＜0.05).Conclusion:PNS reduces ischemia reperfusion injury after intravenous thrombolysis with rt-PA intravenous thrombolysis in patients with acute cerebral infarction,and it may be related with reducing the rate of hemorrhagic transformation after thrombolysis.关键词
急性脑梗死/重组组织型纤溶酶原激活剂/三七总皂甙/缺血再灌注损伤/出血性转化Key words
acute cerebral infarction/recombinant tissue plasminogen activator/panax notoginseng saponins/ischemia reperfusion injury/hemorrhagic transformation
