To investigate the effects of Edaravond-dexcamphenol on oxidative stress, immune function and neurological function in patients with acute cerebral ischemic stroke (CIS) after mechanical thrombectomy.

A prospective study was conducted on 174 CIS patients who underwent mechanical thrombectomy in Neurology Department of Weinan Central Hospital from May 2019 to May 2022. They were randomly divided into an experimental group, a conventional group, and a blank group using a random number table method, with 58 patients in each group. The experimental group was given edaravone deoxycamphor after surgery, the conventional group was given edaravone after surgery, and the blank group received only routine treatment after surgery and was not given edaravone deoxycamphor or edaravone after surgery. Serum indicators, including superoxide dismutase (SOD), malonaldehyde (MDA), oxidized low density lipoprotein (ox-LDL), glutathione peroxidase (GSH-Px), B lymphocytoma-2 (Bcl-2), hypoxic transcription factor-1α (HIF-1α), and matrix metalloproteinase 9 (MMP-9) were measured in three groups of patients before surgery and 2 weeks after treatment. Serum levels of CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ were also measured, and the length of hospital stay and adverse reactions were recorded. The National Institutes of Health stroke scale (NIHSS) scores of the three groups were compared before and 3 and 6 months after the follow-up for 6 months.

After 2 weeks of treatment, the SOD and GSH-Px of three groups were higher than before surgery, and the experimental group was higher than the conventional group and blank group; MDA and ox LDL were lower than preoperative levels, and the experimental group was lower than the conventional group and blank group, with statistically significant differences (P<0.05). After 2 weeks of treatment, HIF-1α and MMP-9 in the three groups were lower than before surgery, and the experimental group was lower than the conventional group and the blank group, and the Bcl-2 in the three groups was higher than before surgery, and the experimental group was higher than the conventional group and the blank group (P<0.05). After 2 weeks of treatment, the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in the three groups were higher than before surgery, and the levels of CD8⁺ were lower than before surgery. The levels of CD4⁺ and CD4⁺/CD8⁺ in the experimental group were higher than those in the conventional group and the blank group, and the differences were statistically significant (P<0.05). There was no difference in the adverse reaction rate among the three groups (P>0.05). The NIHSS scores of the three groups at 3 and 6 months after surgery were lower than those before surgery, and the scores of the experimental group at 3 months after surgery were lower than those of the conventional group and the blank group (P<0.05), and the NIHSS scores of the three groups at 6 months after surgery were not different (P>0.05).

Edaravone dextrocamphorol treatment after mechanical thrombecectomy in acute CIS patients can more effectively relieve oxidative stress, improve immunity, improve short-term neurological deficits, and is safe to use. The mechanism of action may be related to the regulatory effects of HIF-1α, Bcl-2, and MMP-9, but it has no significant improvement on medium-term neurological deficits.