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Ischemic stroke not only has a high incidence in China, but also has a very high mortality rate and disability rate in the world, and the pathogenesis factors of the disease include family history, hypertension and bad living habits
.
The data showed that the mortality rate of ischemic stroke patients undergoing decompression surgery within 6 months after surgery was as high as 31%.
Glybenclamide is a commonly used oral hypoglycemic drug in clinical practice, which belongs to the sulfonylurea class of drugs, has a blocking effect on sulfonylurea receptor 1 (Surl), and is widely used in the
treatment of diabetic patients.
Surl belongs to the ABCC8 gene code and can be involved in the formation and regulation of 2 ion channels, including Surl-Kir 6.
Glybenclamide blocks the Surl-Trpm 4 channel, protects nerve function, reduces brain damage, helps patients restore their ability to live daily, and promotes recovery
.
Efficacy of sulfonylureas in animal models and clinical trials for the treatment of cerebral ischemia
Ø A large number of scholars have shown in experimental processes that the SURl-TRPM4 blocker glibenclamide can play an important role
in the protection of brain function.
Ø Animal experiments and clinical studies have shown that the SUR1-selective inhibitor glibenclamide can alleviate brain damage caused by ischemic reperfusion and provide neuroprotection for ischemic stroke, including reducing infarct volume and improving nerve function, especially to reduce cerebral edema and reduce the incidence of
HT.
Ø Retrospective studies have shown that after the onset of ischemic stroke, the functional outcomes of diabetic patients who continued to take sulfonylureas were significantly improved, while the risk of HT was significantly reduced
.
Ø An exploratory study showed that intravenous infusion of glibenclamide significantly reduced plasma matrix metalloproteinase-9 (MMP-9) levels and vasogenic cerebral edema in stroke patients
.
Ø Animal experiments have shown that the use of glibenclamide helps to reduce the swelling of the damaged hemisphere of MCAO, the experimental data decreased from the original 21% to 8%, the decline was large, and the area of cerebral infarction decreased by 40%, and the mortality rate in 24 hours decreased from the original 67% to 5%)
.
Ø Studies have shown that patients with ischemic stroke with type 2 glucourea disease have a lower score after admission to the hospital and find that patients who have taken glibenclamide have lower scores, and they also have a greater advantage
in the Rankin score for follow-up after discharge.
Ø The latest small-sample clinical studies have reported that glibenclamide has a good effect on cerebral edema and cerebral infarction area after ischemic stroke, and can significantly reduce the incidence of
edema and infarction.
Ø Simord et al.
Ø Kimberly et al.
Ø Horsdal et al.
References:
Kong Delian,Jiang Juan,He Qing.
Zhang Zhicang,Yang Huiping,Li Peijie.
Experimental study on the protection of glibenclamide against brain injury in rats with acute carbon monoxide poisoning[J].
Chinese Journal of Emergency Resuscitation and Disaster Medicine,2018,13(6):553-556.
Zhang Zhicang,Li Peijie.
Progress in the treatment of glibenclamide for acute central system injury[J].
Journal of Lanzhou University (Medical Scienc),2017,43(05):52-62.
DOI:10.
13885/j.
issn.
1000-2812.
2017.
05.
010.
Tan Bei.
Effect of glibenclamide on the prognosis of patients with ischemic stroke[J].
Medical Equipment,2019,32(24):80-81.