摘要目的 研究依达拉奉治疗老年急性缺血性卒中患者认知功能障碍的效果及对丝裂原活化蛋白激酶/细胞外调节蛋白激酶(M APK/ERK )信号通路蛋白表达的影响. 方法 回顾性分析,对河南新乡医学院第一附属医院2011年1月至2015年12月诊治的老年急性缺血性卒中100例患者进行研究,以本院同期健康体检者100例为对照组,分析依达拉奉对患者认知功能障碍的改善作用及治疗前后患者血清中M APK/ERK信号通路相关蛋白表达水平变化. 结果 老年急性缺血性卒中患者认知功能障碍,且记忆力评分、定向力评分、注意力和计算能力评分、语言能力评分及回忆能力评分均降低(均 P＜0.01) ,经依达拉奉治疗后患者认知功能障碍评分得到增加(均 P＜0.01) ;血清中大鼠肉瘤蛋白(Ras)、迅速加速纤维肉瘤(Raf)、低氧诱导因子-1α(HIF-1α)、结缔组织生长因子(CTGF)、细胞外调节蛋白激酶(ERK)和MAPK/ERK激酶(MEK)、白细胞介素1(IL1)、肿瘤坏死因子-α(TNFα)、血管内皮生长因子(VEGF)、金属蛋白酶组织抑制剂(TIMP)及神经生长因子及其受体表达减弱,而瘦素及其受体蛋白表达增强(均 P＜0.01) ,且经依达拉奉治疗后上述因子异常得到恢复(均 P＜0.01). 结论 依达拉奉对老年急性缺血性卒中患者认知功能障碍有较好的改善效果,且能改善患者体内M APK/ERK信号通路蛋白的异常表达水平.

abstractsObjective To investigate the effects of Edaravone on cognitive dysfunction and on protein expression of the mitogen-activated protein kinase/extracellular signal-regulated protein kinase (MAPK/ERK)signaling pathway in elderly patients with acute ischemic stroke. Methods A total of 100 elderly patients with acute ischemic cerebral stroke admitted to our hospital from January 2011 to December 2015 were enrolled in this study.During the corresponding period ,100 healthy individuals receiving regular check-ups were selected as the control group. The effects of Edaravone on cognitive function in elderly patients with acute ischemic cerebral stroke were assessed.Serum proteins related to the MAPK/ERK signaling pathway were assayed. Results Elderly patients with acute ischemic stroke showed obvious cognitive dysfunction ,and scores on memory ,orientation ,attention ,calculation language and recall significantly decreased(P＜0.01)but returned to normal after Edaravone treatment (P＜0.01).Compared with the control group ,serum protein expression of rat sarcoma (Ras) ,rapidly accelerated fibrosarcoma(Raf) ,hypoxia inducible factor-1α(HIF-1α) ,connective tissue growth factor (CTGF),extracellular signal-regulated protein kinase(ERK1),ERK2 ,MAPK/ERK kinase(MEK), interleukin-1(IL-1) ,tumor necrosis factor-α(TNF-α) ,vascular endothelial growth factor (VEGF) , tissue inhibitor of metalloproteinase (TIMP) ,nerve growth factor (NGF)and its receptors was significantly downregulated(P＜0.01) ,while expression of leptin and its receptors was upregulated in elderly patients with acute ischemic cerebral stroke ( P ＜ 0.01 ). Expression levels of the above downregulated proteins clearly recovered after Edaravone treatment ( P ＜ 0.01 ). Conclusions Edaravone has favorable effects on cognition dysfunction in elderly patients with acute ischemic cerebral stroke ,which may be related to the regulation of the MAPK/ERK signaling pathway.