银杏达莫注射液对高血压脑出血神经功能恢复的影响

Influence of Ginkgo Leaf Extract and Dipyridamole Injection on Nerve Function Recovery in Treating Patients with Hypertensive Cerebral Hemorrhage Disease

目的:观察银杏达莫对高血压脑出血(HICH)神经功能恢复的作用及对血浆神经元特异性烯醇化酶(NSE)含量、血清补体C3,C4含量及超敏C-反应蛋白(hs-CRP)的影响。方法:84例HICH患者随机按入院前后顺序分为对照组和观察组各42例。两组均行CT引导下行微创碎吸术,术后给予脱水降颅压、控制血压、防治感染、营养神经、对症等西医基础治疗。观察组加用银杏达莫注射液,每次20 m L,静脉滴注,2次/d。两组疗程均为14 d。进行治疗前后美国国立卫生院神经功能缺损(NIHSS)评分、格拉斯哥昏迷评分(GCS)评分和运动功能评价量表(Fugl-Meyer)评分;检测治疗前后血浆NSE,血清C3,C4及hs-CRP水平。于治疗前、治疗后7,14 d进行NIHSS、格拉斯哥昏迷指数(GCS)和运动功能评价量表(Fugl-Meyer)评分;采用核磁共振成像(MRI)检查评估治疗前后中线结构移位情况;检测治疗后血浆神经元特异性烯醇化酶(NSE)含量、hsCRP、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平。结果:经Ridit分析,治疗后观察组临床疗效优于对照组(P<0.05);观察组NIHSS和GCS评分低于对照组(P<0.01);治疗后观察组Fugl-Meyer评分高于对照组(P<0.01);观察组的中线结构移位情况改善优于对照组(P<0.01);治疗后观察组NSE,hs-CRP,IL-6和TNF-α水平低于对照组(P<0.01)。结论:在西医常规治疗的基础上,银杏达莫注射液用于HICH微创术后患者能改善神经缺损功能,促进患者觉醒,其作用机制可能是通过减轻脑水肿和炎症反应来实现的。

Objective： To observe the effect of Ginkgo leaf extract and dipyridamole injection on nerve function recovery in treating hypertensive cerebral hemorrhage （HICH） , and to investigate its influence amount of neuron-specific enolase （NSE）, serum complement C3, C4 and high sensitive C reactive protein （hs-CRP）. Method： Eighty-four patients with HICI were divided into the control group （42 cases） and the observation group （42 cases） according to the order of admission. Patients in two groups received CT guided minimally invasive surgery. After surgery, they received conventional Western medicine treatment including intracranial pressure lowering, blood pressure control, infection control, nerve nutrition, symptomatic, etc. Patients in the observation group added 20 mL Ginkgo leaf extract and dipyridamole injection for intravenous drip twice daily. All patients in both two groups received 14 days of treatment. American nerve function defect of the National Institutes of Health （NIHSS） scores, glasgow coma score （GCS）, Fugl-Meyer motor function measure evaluation scores were conducted before and after treatment. Blood plasma NSE, serum C3, C4 and hs-CRP levels were detected. At the seventh and fourteenth day after therapy, NIHSS scores, glasgow coma score （GCS） , Fugl-Meyer motor function measure evaluation scores were conducted. The middle line shift situation was evaluated via MRI before and after treatment. Neuron-specific enolase （NSE） , serum complement C3, C4 and high sensitive C reactive protein （hs- CRP）, tumor necrosis-α （TNF-α） and interleukin 6 （IL-6） were tested before and after treatment. Result： The total clinical curative rate in the observation group was superior to that in the control group （P 〈 0.05 ）. NIHSS and GCS scores in the observation group were lower than those in the control group （P 〈 0.01 ）. After treatment,Fugl-Meyer score in the observation group was higher than that in the control group （P 〈 0.01 ）. The improvement of middle line shift situation in the observation group was superior to that in the control group （P 〈 0.01 ）. Levels of NSE, hs-CRP, IL-6 and TNF-α in the observation group were lower than those in the control group （P 〈 0.01 ）. Conclusion： Based on conventional treatment of Western medicine, Ginkgo leaf extract and dipyridamole injection could improve defect of nerve function in HICH patients after minimally invasive surgery, and promote their awakening. The mechanism may be achieved by reducing brain edema and inflammatory reaction.