目的 探討依達拉奉治療急性腦梗死的臨床療效和作用機制。方法 選擇2011年3月-2013年3月就診于中國醫(yī)科大學附屬第一醫(yī)院的急性腦梗死患者121例，隨機分為對照組（60例）和治療組（61例）。對照組采用常規(guī)治療，治療組加用依達拉奉注射液10 mg/次，加入0.9%氯化鈉溶液100 mL，靜脈滴注，2次/d，10 d為1個療程。治療1～2個療程后比較兩組治療前，治療5、10 d，治療結(jié)束時神經(jīng)功能缺損（NIHSS）評分、促炎/抑炎細胞因子、自由基的情況。結(jié)果 治療組和對照組治療的有效率分別是83.61%、61.67%，兩組比較差異有統(tǒng)計學意義（P<0.05）。兩組患者經(jīng)治療后，NIHSS評分均較治療前有所下降，同組治療前后差異有統(tǒng)計學意義（P<0.05、0.01）；治療5、10 d，治療結(jié)束時治療組NIHSS評分均顯著低于同一時間點對照組的評分，兩組差異有統(tǒng)計學意義（P<0.05、0.01）。從治療10 d開始，兩組患者白細胞介素6（IL-6）、內(nèi)皮素1（ET-1）、丙二醛（MDA）均較治療前有所下降，白細胞介素13（IL-13）、超氧化物歧化酶（SOD）均較治療前有所升高，同組治療前后差異有統(tǒng)計學意義（P<0.05、0.01）。治療組IL-6和ET-1在治療5、10 d，治療結(jié)束后與對照組差異有統(tǒng)計學意義（P<0.01）；治療組IL-13、SOD水平在治療10 d、治療結(jié)束時與對照組差異有統(tǒng)計學意義（P<0.01）；治療組MDA水平在治療結(jié)束后與對照組的差異有統(tǒng)計學意義（P<0.01）。結(jié)論 依達拉奉能對急性腦梗死患者具有較好的療效，其作用可能與清除自由基和抑制炎性氧化應激有關(guān)。

Objective To explore the clinical effect and mechanism of edaravone in the treatment of acute cerebral infarction. Methods Patients (121 cases) with acute cerebral infarction from March 2011 to March 2013 for the treatment in the First Affiliated Hospital of China Medical University were randomly divided into control (60 cases) and treatment (61 cases) groups. The patients in the control group accepted conventional treatment, and those in the treatment group treated with Edaravone Injection 30 mg add 0.9% sodium chloride solution 100 mL, iv infusion, 2 times/d, 10 d for one courses. NIHSS, proinflammatory/anti inflammatory cytokines, free radicals of before treatment, treatment for 5 and 10 d were compared after 1-2 courses treatment. Results The efficacy on the patients in the treatment and control groups were 83.61% and 61.67%, and there was significant difference between the two groups (P < 0.05). After the treatment, the NIHSS scores in the two groups were decreased, and there was statistical significance before and after the treatment (P < 0.05,0.01); NIHSS score in the treatment group was significantly lower than that in the same time point in the control group for 5/10 d and at the end of the treatment (P < 0.05, 0.01). From the treatment of 10 d, interleukin 6 (IL-6), endothelin 1 (ET-1), and malondialdehyde (MDA) were decreased, while interleukin 13 (IL-13) and superoxide dismutase (SOD) were more increased than before the treatment in the two groups. The difference was statistically significant (P < 0.05, 0.01). The IL-6 and ET-1 of 5, 10 d and at the end of the treatment in treatment group were different compared with the control group, and the difference was statistically significant (P < 0.01). The IL-13 and the level of SOD in 10 d and at the end of the treatment in the treatment group were different compared with the control group (P < 0.01). At the end of the treatment,the level of MDA in the treatment and control groups was statistically significant (P < 0.01). Conclusion Edaravone have the good therapeutic effect on acute cerebral infarction patients, the mechanism may be related to scavenging free radicals and inhibiting inflammatory oxidative stress.