Sodium Tanshinone IIA Sulfonate Enhances Effectiveness Rt-PA Treatment in Acute Ischemic Stroke Patients Associated with Ameliorating Blood-Brain Barrier Damage.
Sodium Tanshinone IIA Sulfonate Enhances Effectiveness Rt-PA Treatment in Acute Ischemic Stroke Patients Associated with Ameliorating Blood-Brain Barrier Damage.
复制标题
丹参酮 IIA 磺酸钠可提高急性缺血性中风患者 Rt-PA 治疗的有效性，并改善血脑屏障损伤
DOI：
10.1007/s12975-017-0526-6
复制
发表时间：
2017-08
影响因子：
6.9
通讯作者：
Xu Y
中科院分区：
文献类型：
--
作者：
Ji B;Zhou F;Han L;Yang J;Fan H;Li S;Li J;Zhang X;Wang X;Chen X;Xu Y
丹参酮Ⅱ A磺酸钠（STS）治疗急性缺血性脑卒中患者，可改善重组组织型纤溶酶原激活剂（rt-PA）溶栓对血脑屏障（BBB）的损害，改善患者预后。这项随机、单中心、安慰剂对照的临床试验研究了STS的潜在作用和潜在机制。42例接受静脉rt-PA溶栓治疗的急性缺血性卒中患者随机分为STS（60 mg/天）（n = 21）或与安慰剂等体积的生理盐水（n = 21）静脉给药组，随机分组后持续10天。比较两组的临床结局、计算机断层扫描灌注（CTP）成像和渗透率-表面积乘积（PS）图以及血脑屏障损伤生物标志物的血清水平。STS组中90天mRS ≤1的功能结局极佳的患者百分比显著高于安慰剂组（p = 0.028）。对于CTP成像患者（n = 30），STS组同侧病变的PS（p = 0.034）和相对PS（p = 0.013）显著低于安慰剂组。STS治疗组患者的基质金属蛋白酶（MMP）-9（p = 0.036）和密蛋白-5（p = 0.026）水平也低于安慰剂组，但金属蛋白酶组织抑制剂（TIMP）-1（p = 0.040）水平高于安慰剂组。卒中后STS治疗可通过减少BBB渗漏和损伤改善rt-PA治疗后急性缺血性卒中患者的神经功能结局，这可能与MMP-9抑制有关。
Treatment with sodium tanshinone IIA sulfonate (STS) may ameliorate blood-brain barrier (BBB) damage in acute ischemic stroke patients receiving recombinant tissue plasminogen activator (rt-PA) thrombolysis and improve stroke patients’ outcome. This randomized, single-center, placebo-controlled clinical trial investigated the potential effects and underlying mechanisms of STS. Forty-two acute ischemic stroke patients receiving intravenous rt-PA thrombolysis were randomized to intravenous administration either with STS (60 mg/day) (n = 21) or with equivalent volume of saline as a placebo (n = 21) after randomization for 10 days. Clinical outcomes, computer tomography perfusion (CTP) imaging with permeability-surface area product (PS) maps and serum levels of BBB damage biomarkers, were compared between the two groups. The percentage of patients with excellent functional outcome indicated by a 90-day mRS ≤1 was significantly higher in the STS group than in the placebo group (p = 0.028). For patients with CTP imaging (n = 30), PS in the ipsilateral lesion (p = 0.034) and relative PS (p = 0.013) were significantly lower in the STS group than that in placebo. STS-treated patients also had lower levels of matrix metalloproteinase (MMP)-9 (p = 0.036) and claudin-5 (p = 0.026), but higher levels of tissue inhibitor of metalloproteinase (TIMP)-1 (p = 0.040) than those in the placebo group. Post-stroke STS treatment could improve neurologic functional outcomes for acute ischemic stroke patients following rt-PA treatment by reducing BBB leakage and damage, which might be mechanistically associated with MMP-9 inhibition.