银杏叶提取物对高血压脑出血术后患者神经功能、血清炎症因子、MMP-9和AQP-4水平的影响

Effects of Ginkgo biloba extract on nerve function,serum inflammatory factors and MMP-9 and AQP-4 levels in patients with hypertensive intracerebral hemorrhage after surgery

目的探究银杏叶提取物对高血压脑出血术后患者神经功能、血清炎症因子、基质金属蛋白酶-9(MMP-9)和水通道蛋白4(AQP-4)水平的影响。方法选择于2015年12月至2017年12月间于我院就诊的98例高血压性脑出血患者,采用随机数表法分为治疗组(49例)和对照组(49例),对照组给予微创颅内血肿清除术和对症支持治疗,治疗组在对照组的基础上先后应用银杏叶提取物注射液(10 d)和银杏叶提取物滴剂(30 d)。比较两组患者治疗前后的神经功能、生活能力、生活质量和预后,以及血清炎症因子、MMP-9和AQP-4水平。结果治疗5、10、15 d后,两组患者的美国国立卫生研究院卒中量表(NIHSS)评分均出现明显降低(P <0. 05),治疗组的NIHSS评分均显著低于对照组(t=2. 560、2. 849、3. 400,P <0. 05);治疗10 d后,两组患者的IL-6、TNF-α、hs-CRP、MMP-9和AQP-4水平均较治疗前降低(P <0. 05),治疗组的上述指标水平均显著低于对照组(t=2. 731、4. 110、3. 043、7. 497、4. 774,P <0. 05);治疗30 d后,治疗组的改良Rankin量表(mRS)评级≤2的比例明显高于对照组(χ~2=4. 460,P <0. 05),改良Barthel指数(MBI)评分和脑卒中专门生活质量量表(SS-QOL)评分均显著高于对照组(t=4. 061,6. 197,P <0. 05)。结论银杏叶提取物能够改善高血压脑出血术后患者神经功能、生活能力和生活质量,调节血清炎症因子和MMP-9、AQP-4水平。

Objective To observe the effects of Ginkgo biloba extract on nerve function,serum inflammatory factors and M M P-9 and AQP-4 levels in patients with hypertensive intracerebral hemorrhage. Methods Totally 98 patients with hypertensive intracerebral hemorrhage in our hospital from December 2015 to December 2017 were divided into treatment group（ n = 49） and control group（ n = 49） by random number table; control group received the minimally invasive removal of intracranial hematoma and symptomatic treatment. On the basis of treatment for control group,patients in treatment group were treated with extract of Ginkgo biloba leaves injection（ 10 d） and extract of Ginkgo biloba leaves drops（ 30 d）. Neurological function,viability,quality of life and prognosis,and serum levels of inflammatory factors,M M P-9 and AQP-4 were compared between the two groups before and after treatment. Results After 5,10,and 15 days of treatment,the NIHSS scores of the two groups decreased significantly（ P〈0. 05）. The NIHSS scores of treatment group were significantly lower than those of control group（ t = 2. 560,2. 849,3. 400,P〈0. 05）. After 10 days of treatment,the levels of IL-6,TNF-α,hs-CRP,M M P-9 and AQP-4 in both groups were decreased（ P〈0. 05）,and the levels of the above indexes in treatment group were significantly lower than those in control group（ t = 2. 731,4. 110,3. 043,7. 497,4. 774,P〈0. 05）. After 30 days of treatment,the ratio of mRS≤2 in treatment group was significantly higher than that of control group（ χ~2= 4. 460,P〈0. 05）,and the M BI score and SS-QOL score were significantly higher than those in control group（ t = 4. 061,6. 197,P〈0. 05）. Conclusion Ginkgo biloba extract can improve neurological function,life ability and quality of life in patients with hypertensive intracerebral hemorrhage,and regulate the serum inflammatory cytokines and levels of M M P-9 and AQP-4 obviously.