依达拉奉联合阿替普酶治疗老年急性缺血性脑卒中的疗效及对患者睡眠质量、焦虑抑郁的影响

Efficacy of edaravone combined with alteplase in elderly patients with acute ischemic stroke and its effects on sleep quality, anxiety and depression

摘要

目的 探究依达拉奉联合阿替普酶治疗老年急性缺血性脑卒中 (AIS) 的疗效及对患者睡眠质量、焦虑抑郁的影响。方法 选取 2023 年 1 月-2025 年 1 月邯郸市中心医院收治的 120 例 AIS 老年患者作为研究对象, 按照随机数字表法分为对照组 (采用阿替普酶进行治疗, 60 例) 和试验组 (采用依达拉奉联合阿替普酶进行治疗, 60 例)。比较两组神经功能 [美国国立卫生研究院脑卒中量表 (NIHSS)]、血清炎性因子指标 [白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)]、睡眠质量 [匹兹堡睡眠质量指数量表 (PSQI)]、焦虑和抑郁程度 [汉密尔顿焦虑量表 (HAMA)、汉密尔顿抑郁量表 (HAMD)]、临床疗效以及不良反应发生情况。结果 治疗后, 试验组 NIHSS 评分低于对照组 (P<0.05), IL-6、TNF-α 水平均低于对照组 (P<0.05), PSQI 评分、HAMA 评分以及 HAMD 评分均低于对照组 (P<0.05), 试验组总有效率高于对照组 (P<0.05); 两组不良反应总发生率比较, 差异无统计学意义 (P>0.05)。结论 依达拉奉联合阿替普酶能够有效提高 AIS 老年患者的神经功能、睡眠质量, 降低焦虑、抑郁程度, 改善血清炎性因子指标, 提高临床疗效, 且不增加不良反应。

Abstract

Objective To investigate the efficacy of edaravone combined with alteplase in the treatment of elderly patients with acute ischemic stroke (AIS) and its effects on patients' sleep quality, anxiety and depression. Methods A total of 120 elderly patients with acute ischemic stroke (AIS) admitted to Handan Central Hospital from January 2023 to January 2025 were enrolled as research subjects, they were randomly divided into the reference group (treated with alteplase, 60 cases) and the experimental group (treated with edaravone combined with alteplase, 60 cases) by the random number table method. The neurological function [National Institutes of health stroke scale (NIHSS)], serum inflammatory factor indicators [Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], sleep quality [Pittsburgh sleep quality index (PSQI)], anxiety and depression levels [Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD)], clinical efficacy, and adverse reactions were compared between the two groups. Results After treatment, the NIHSS score in the experimental group was lower than that in the control group (P<0.05); the levels of IL-6 and TNF-α were lower than those in the control group (P<0.05); the PSQI, HAMA and HAMD scores were all lower than those in the control group (P<0.05); the total effective rate of the experimental group was higher than that of the control group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion Edaravone combined with alteplase can effectively improve neurological function and sleep quality, relieve anxiety and depression, reduce serum levels of inflammatory factors, enhance clinical efficacy in elderly patients with AIS, without increasing adverse reactions.

关键词

急性缺血性脑卒中 / 依达拉奉 / 阿替普酶 / 睡眠质量 / 焦虑 / 抑郁

Key words

Acute ischemic stroke / Edaravone / Alteplase / Sleep quality / Anxiety / Depression

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基金资助

邯郸市科学技术研究与发展计划项目(23422083230)