银杏内酯注射液联合巴曲酶治疗急性脑梗死的临床研究

目的探讨银杏内酯注射液联合巴曲酶治疗急性脑梗死的临床疗效。方法选取2015年2月—2019年2月在河南医学高等专科学校附属医院治疗的急性脑梗死患者78例,根据用药的不同分为对照组(39例)和治疗组(39例)。对照组静脉滴注巴曲酶注射液,首次10 BU加入生理盐水100 mL,隔日5 BU加入生理盐水100 mL,1次/2 d;治疗组在对照组基础上静脉滴注银杏内酯注射液,10 mL加入生理盐水250 mL,1次/d。两组患者均治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者NIHSS评分、m RS评分、MoCA评分、SF-36评分、ADL评分、BI指数,血清血红素氧合酶1(HO1)、单核细胞趋化蛋白-1(MCP-1)、亲环素A(CyPA)、和肽素(CPP)、神经胶质纤维酸性蛋白(GFAP)和基质金属蛋白酶-9(MMP-9)水平,双侧大脑中动脉动脉峰流速(Vp)、平均流速(Vm)、流速差值(DVp、DVm),及血液红细胞压积(HCT)、全血黏度(WBV)、纤维蛋白原(FIB)和血浆黏度(PV)水平。结果治疗后,对照组临床有效率为82.05%,显著低于治疗组的97.44%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者NIHSS和m RS评分显著降低(P0.05),MoCA评分、SF-36评分、ADL评分和BI指数评分显著升高(P0.05),且治疗组NIHSS、m RS、MoCA、SF-36、ADL和BI指数评分明显好于对照组(P0.05)。治疗后,两组血清HO1、MCP-1、Cy PA、CPP、GFAP、MMP-9水平均明显下降(P0.05),且治疗组HO1、MCP-1、CyPA、CPP、GFAP、MMP-9水平明显低于对照组(P0.05)。治疗后,两组患者双侧大脑中动脉Vp、Vm均增高(P0.05),DVp、DVm明显降低(P0.05),且治疗组脑血流动力学水平明显好于对照组(P0.05)。治疗后,两组患者HCT、WBV、FIB及PV水平明显降低(P0.05),且治疗组这些血液流变学指标明显低于对照组(P0.05)。结论银杏内酯注射液联合巴曲酶注射液治疗急性脑梗死有利于促进患者脑神经功能恢复,改善机体细胞因子水平,促进机体血液流变学及脑血流动力学指标的改善。

Clinical study on Ginkgolide Injection combined with batroxobin in treatment of acute cerebral infarction

Objective To investigate the clinical efficacy of Ginkgolide Injection combined with batroxobin in treatment of acute cerebral infarction. Methods Patients (78 cases) with acute cerebral infarction in Henan Medical College Hospital Workers from February 2015 to February 2019 were divided into control (39 cases) and treatment (39 cases) groups based on different treatments. Patients in the control group were iv administered with Batroxobin Injection, 10 BU added into normal saline 100 mL for the first time, then 5 BU added into normal saline 100 mL on the alternate day, once every two days. Patients in the treatment group were iv administered with Ginkgolide Injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the scores of NIHSS, mRS, MoCA, SF-36, ADL and BI, serum levels of HO1, MCP-1, CyPA, CPP, GFAP and MMP-9, Vp, Vm, DVp and DVm of bilateral brain, and HCT, WBV, FIB, PV levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 82.05%, which was significantly lower than 97.44% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the NIHSS and mRS scores in two groups were significantly decreased (P<0.05), but MoCA, SF-36, ADL and BI scores were significantly increased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of HO1, MCP-1, CyPA, CPP, GFAP and MMP-9 in two groups were significantly decreased (P<0.05), and these serum indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the Vp and Vm of bilateral brain in two groups were significantly increased (P<0.05), but DVp and DVm of bilateral brain were significantly decreased (P<0.05), and the cerebral hemodynamic parameters in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the HCT, WBV, FIB, and PV levels in two groups were significantly decreased (P<0.05), and these hemorheological indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Ginkgolide Injection combined with batroxobin in treatment of acute cerebral infarction can promote the recovery of nerve function, improve the level of cytokines, promote the improvement of hemorheology and cerebral hemodynamics.