联合心脑宁胶囊对脑梗死恢复期患者HMGB1/TLR4/NF-κB通路及脑中动脉血流的影响OACSTPCD

Objective To analyze the effects of combined Xinnaoning capsule on high mobility group protein B1(HMGB1)/Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)pathway and middle cerebral artery blood flow in pa-tients with convalescent cerebral infarction.Methods A total of 82 patients with convalescent cerebral infarction admitted from January 2019 to October 2023 were selected.Using the lottery method,patients treated with Edaravone were assigned to Edaravone group,and the patients treated with Edaravone combined with Xinnaoning capsule were assigned to combined Xinn-aoning group,with 41 cases in each group.Both groups were treated for 2 weeks.The clinical efficacy of the two groups at 2 weeks after treatment and the occurrence of adverse reactions during treatment were analyzed.Serum HMGB1/TLR4/NF-κB pathway index level,nerve injury index level,cerebral middle artery-related blood flow parameters,nerve function,cognitive function and life ability of the two groups were compared before and at 2 weeks after treatment.Results At 2 weeks after treatment,the total effective rate of combined Xinnaoning group was92.68%,which was higher than that of Edaravone group(73.17%)(P＜0.05).At 2 weeks after treatment,serum levels of HMGB1,TLR4 and NF-κB in the two groups were de-creased,which were lower in combined Xinnaoning group than in Edaravone group(P＜0.05,P＜0.01).At 2 weeks after treatment,the serum levels of neuron-specific enolase(NSE),central nervous system specific protein β(S100β)and neuro-trophic factor-3(NT-3)in the two groups were decreased,while the levels of brain-derived neurotrophic factor(BDNF)were increased.The decrease in the levels of serum NSE,S100β and NT-3 and the increase in BDNF in the combined Xinnaning group were greater than those in Edaravone group(P＜0.05,P＜0.01).At 2 weeks after treatment,the mean flow velocity(Vm)of cerebral artery was increased in the two groups,and the cerebral artery resistance index(RI)and pulse index(PI)were decreased,and the increase of cerebral artery Vm and the decrease of RI and PI in combined Xinnaoning group were greater than those in Edaravone group(P＜0.05,P＜0.01).At 2 weeks after treatment,the National Institutes of Health stroke scale(NIHSS)score was reduced,while the Montreal cognitive assessment scale(MoCA)and modified Barthel index(MBI)score were increased;the decrease in NIHSS score and the increase in MoCA and MBI scores were greater than those in Edaravone group(P＜0.05,P＜0.01).During treatment,there was no significant difference in the total incidence of ad-verse reactions between the two groups(P＞0.05).Conclusion Xinnaoning capsule combined with Edaravone can effective-ly regulate the expression level of HMGB1/TLR4/NF-κB pathway,alleviate nerve injury,improve middle cerebral artery blood flow,and improve nerve function,cognitive function and life ability of patients with convalescent cerebral infarction,with good clinical efficacy and safety.