银杏内酯注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的临床对照研究

Clinical study on Ginkgo biloba lactone injection combined with rt-PA intravenous thrombolysis in treatment of acute ischemic stroke

目的探讨银杏内酯注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的安全性及临床疗效。方法选取87例急性缺血性脑卒中患者,分为对照组及试验组。对照组39例,给予阿替普酶静脉溶栓治疗,10%注射用阿替普酶(0.9 mg/kg)iv,其余90%在1 h内静脉滴注完毕,后给予生理盐水iv,24 h后给予缺血性卒中的基础用药;试验组48例,在相同方法静脉溶栓后立刻给予银杏内酯注射液,6 m L加入250 m L生理盐水中,静脉滴注,1次/d,连续用药14 d,溶栓24 h后给予缺血性卒中的基础用药。所有入选患者分别于治疗前、治疗后14、90 d记录美国国立卫生研究院卒中量表(NIHSS)评分,并记录不良反应事件,治疗后14、90 d进行改良Rankin量表(m RS)评分1次、检测BI指数1次。按照TOAST分型将两组患者进行分类,并对大动脉粥样硬化型及小动脉闭塞型患者进行分析。结果两组患者用药后均未出现颅内出血;用药后90 d,试验组的NIHSS评分、m RS评分较对照组显著降低,BI指数显著升高;试验组的大动脉粥样硬化型患者用药后90 d的NIHSS评分、m RS评分较对照组明显降低,BI指数显著升高;而小动脉粥样硬化型患者与对照组比较差异不显著。结论银杏内酯注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中患者安全性高,且明显改善患者预后。

Objective To explore the safety and clinical efficacy of Ginkgo biloba lactone injection combined with Alteplase intravenous thrombolysis in treatment of acute ischemic stroke.Methods Totally 87 patients were recruited and divided into control group and test group.The,patients in control group （39 cases） were given Alteplase 0.9 mg/kg for injection,intravenous bolus total dose 10% was given within 1 min,then intravenous infusion of the remaining 90% was given in 1 h,and given basic therapy after 24 h.The 48 cases in test group,which were immediately iv Ginkgo biloba lactone injection after intravenous thrombolysis,6 mL added into 250 mL saline,once daily for 14 d,and also were given basic therapy after 24 h.All NIHSS scores were recorded before treatment,14 d and 90 d after treatment,and the adverse events were recorded.The modified Rankin scale （mRS） score and BI index were performed at 14 and 90 d after admission.Patients in two groups were classified according to the TOAST classification,and the patients with large-arteryatherosclerosis and small-artery occlusion were analyzed.Results No intracranial hemorrhage occurred in the two groups.The NIHSS score and mRS score of test group were significantly lower than that of control group,and BI index was significantly increased 90 d after treatment.The NIHSS score and mRS score of test group were significantly lower than that of control group,and BI index was significantly increased90 d after treatment of patients with large-artery atherosclerosis.But there was no significant difference between test group and control group of patients with small-artery occlusion.Conclusion Ginkgo biloba lactone injection combined with rt-PA intravenous thrombolysis in the treatment of acute ischemic stroke has high safety,and can improve the prognosis of patients.