高血压脑出血围手术期银杏内酯注射液辅助治疗对神经功能恢复的影响

Effects of adjuvant ginkgolide injection therapy in perioperative period of hypertensive cerebral hemorrhage on neural functional recovery

目的:研究高血压脑出血围手术期银杏内酯注射液辅助治疗对神经功能恢复的影响。方法:选择北京市顺义区中医医院2015年6月～2017年10月期间进行血肿清除术的高血压脑出血病例,回顾病史资料并根据围手术期是否使用银杏内酯注射液分为银杏内酯组和常规对照组。治疗前及治疗后7d时,测定血清中神经损伤标志物、炎症应激介质的含量及外周血中炎症应激信号分子的表达量。结果:与组内治疗前比较,两组患者治疗后7d时血清中GNS、BDNF的含量以及外周血中Wnt1、GSK-3β、β-catenin的表达量均显著升高,血清中Tau、NSE、OPN、MIF、HMGB1、TNF-α、MDA的含量以及外周血中eNOS、p38MAPK的表达量均显著降低且银杏内酯组患者治疗后7天时血清中GNS、BDNF的含量以及外周血中Wnt1、GSK-3β、β-catenin的表达量均高于常规对照组,血清中Tau、NSE、OPN、MIF、HMGB1、TNF-α、MDA的含量以及外周血中eNOS、p38MAPK的表达量低于常规对照组。结论:高血压脑出血围手术期银杏内酯注射液辅助治疗能够减轻神经损伤程度、抑制炎症应激程度。

Objective：To study the effects of adjuvant ginkgolide injection therapy in perioperative period of hypertensive cerebral hemorrhage on neural functional recovery.Methods：Patients with hypertensive cerebral hemorrhage who underwent evacuation of hematoma in Traditional Chinese Medicine Hospital of Shunyi District Beijing between June 2015 and October 2017 were selected and divided into ginkgolide group and normal control group according to the perioperative application of ginkgolide injection or not in the history data.The levels of nerve injury markers and inflammatory stress mediators in serum as well as the expression of inflammatory stress signal molecules in peripheral blood were measured before treatment and 7 dafter treatment.Results：Compared with same group before treatment,serum GNS and BDNF levels as well as peripheral blood Wnt1,GSK-3βandβ-catenin expression of both groups of patients were significantly higher whereas serum Tau,NSE,OPN,MIF,HMGB1,TNF-αand MDA levels as well as peripheral blood eNOS and p38 MAPK expression were significantly lower 7 d after treatment,and serum GNS and BDNF levels as well as peripheral blood Wnt1,GSK-3βandβ-catenin expression of ginkgolide group 7 dafter treatment were higher than those of normal control group whereas serum Tau,NSE,OPN,MIF,HMGB1,TNF-αand MDA levels as well as peripheral blood eNOS and p38 MAPK expression were lower than those of normal control group.Conclusion：Adjuvant ginkgolide injection therapy in perioperative period of hypertensive cerebral hemorrhage can reduce the degree of nerve injury and inhibit the degree of inflammatory stress.