The effect of intravenous thrombolysis with alteplase combined with edaravone and dexborneol in the treatment of H-type hypertension with first-episode cerebral infarction and changes of pro-inflammatory cytokine levels

Song Lingling; Lan Xiaoyan; Huang Gelun; Qiu Yu; Wen Deshu

doi:10.3760/j.issn.1673-4777.2025.07.009

Abstract：Objective To observe the effect of early application of edaravone and dexborneol in the treatment of H-type hypertension with first stroke after intravenous thrombolysis with alteplase and changes of pro-inflammatory cytokine levels.Methods A total of 140 patients with H-type hypertension and first-episode cerebral infarction admitted to the Third People's Hospital of Nanning,Guangxi Zhuang Autonomous Region from January 2020 to December 2023 were enrolled.All patients received intravenous thrombolysis with alteplase,as well as edaravone and dexborneol was given intravenous infusion within 24 h after thrombolysis.The clinical efficacy was evaluated after 14 d of treatment,and the levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with different treatment effects were compared.Restricted cubic spline model(RCS)was used to analyze the relationship between the above indicators and the treatment effect.Results After 14 d of treatment,2 cases were cured,69 cases were markedly effective,44 cases were effective,and 25 cases were ineffective.There were 115 cases(82.1％)in the effective group and 25 cases(17.9％)in the ineffective group.The infarct size and the National Institutes of Health Stroke Scale score after 14 d of treatment in the ineffective group were greater/higher than those in the effective group(all P＜0.05).At 12,24 and 72 h after treatment,the levels of hs-CRP,IL-6,TNF-α and homocysteine in the ineffective group were higher than those in the effective group(all P＜0.05).RCS analysis showed that the levels of hs-CRP,IL-6 and TNF-α had a non-linear dose-response relationship with the response to intravenous thrombolysis combined with edaravone and desborneol.The incidence of poor 90-day prognosis in patients with high hs-CRP,IL-6 and TNF-α levels was higher than that in patients with low hs-CRP,IL-6 and TNF-α levels(all P＜0.05).Conclusion Early administration of edaravone and dexborneol after intravenous thrombolysis in patients with H-type hypertension and cerebral infarction could provide cerebral protection.The levels of hs-CRP,IL-6 and TNF-α showed non-linear dose-response relationship with the therapeutic effect.