银杏二萜内酯葡胺注射液对急性缺血性脑卒中再通成功患者预后的影响

Effect of Diterpene Ginkgolides Meglumine Injection on prognosis of patients with successful recanalization of acute ischemic stroke

目的观察银杏二萜内酯葡胺注射液(DGMI)对急性缺血性脑卒中(AIS)再通成功患者预后的影响。方法回顾性选取南京大学医学院附属鼓楼医院和南京医科大学第一附属医院2016年6月—2021年12月收治的AIS再通治疗患者为研究对象,共纳入颈内动脉或大脑中动脉闭塞者206例。根据再通治疗后3 d头颅磁共振血管造影(MRA)检查结果,将206例患者分为开通成功患者(n=157,其中61例接受DGMI治疗)和开通失败患者(n=49,其中21接例受DGMI治疗);以患者是否接受过DGMI治疗为依据,将接受DGMI治疗≥7 d的患者设为试验组(n=82),未接受DGMI治疗的为对照组(n=124)。收集的临床资料包括年龄、性别、发病至干预时间、干预方式、不良事件(症状性脑出血、死亡)、发病时和90 d的美国国立卫生研究院卒中量表(NIHSS)评分和改良Rankin评分量表(mRS)评分。分别比较开通成功患者和开通失败患者中对照组和试验组间不良事件发生率和预后的差异,包括症状性脑出血率、死亡率,以及90 d后的NIHSS改善率和mRS评分。结果开通成功患者中,试验组90 d NIHSS改善率和mRS评分均明显优于对照组(P<0.05);而在开通失败患者中两组间90 d NIHSS改善率和mRS评分比较,差异无统计学意义(P>0.05);对照组和试验组的症状性脑出血率和死亡率在两亚组中均无明显差异(P>0.05)。结论对于接受再通治疗的AIS患者,DGMI有利于再通成功患者的神经功能改善,且不增加不良事件发生风险。

Objective To study the effect of Diterpene Ginkgolides Meglumine Injection(DGMI)on the prognosis of patients with successful recanalization of acute ischemic stroke(AIS).Methods A total of 206 patients with internal carotid artery or middle cerebral artery occlusion who were admitted to the Nanjing Drum Tower Hospital Affiliated Hospital of Nanjing University Medical School and the First Affiliated Hospital of Nanjing Medical University from June 2016 to December 2021 were selected as the study subjects.According to the results of skull magnetic resonance angiography(MRA)three days after recanalization treatment,206 patients were divided into two groups:successful patients(n=157,of which 61 were treated with DGMI)and failed patients(n=49,of which 21 were treated with DGMI).Based on whether the patients have received DGMI treatment,the patients who have received DGMI treatment for≥7 days are set as the experimental group(n=82),and the patients who have not received DGMI treatment are set as the control group(n=124).The clinical data collected included age,sex,time from onset to intervention,intervention mode,adverse events(symptomatic cerebral hemorrhage,death),the National Institutes of Health Stroke Scale(NIHSS)score and the modified Rankin Scale(mRS)score at the time of onset and 90 days.The difference in the incidence of adverse events and prognosis between the control group and the experimental group,including the rate of symptomatic intracerebral hemorrhage,mortality,and the improvement rate of NIHSS and mRS score after 90 days,were compared between the patients with successful and failed opening.Results The improvement rate of NIHSS and mRS score in the experimental group at 90 days were significantly better than those in the control group(P<0.05).However,there was no significant difference between the two groups in the improvement rate of NIHSS and mRS score at 90 days in patients with failed opening(P>0.05).There was no significant difference in the rate of symptomatic intracerebral hemorrhage and mortality between the two groups(P>0.05).Conclusion For AIS patients receiving recanalization treatment,DGMI is beneficial to the improvement of neurological function in patients with successful recanalization without increasing the risk of adverse events.