银杏内酯联合依达拉奉对老年急性脑梗死患者脑功能影响及缺血再灌注损伤的预防作用

The influence of ginkgolide combined with edaravone on the brain function in elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury

目的:探讨银杏内酯联合依达拉奉对老年急性脑梗死患者的脑功能影响及对缺血再灌注损伤的预防作用。方法:选择2014年4月~2017年5月间达州市中心医院收治的126例急性脑梗死患者根据治疗方案不同分为对照组67例、银杏内酯组59例。对照组接受常规静脉溶栓+依达拉奉治疗,银杏内酯组接受常规静脉溶栓+依达拉奉+银杏内酯治疗。对比两组治脑功能及神经缺血再灌注损伤程度的差异。结果:治疗1周后(T1)、治疗4周后(T2),银杏内酯组血清中神经功能指标NT-proBNP、NSE的含量低于对照组,BDNF的含量高于对照组;血清中炎症介质MCP-1、NF-κB、CRP、TNF-α的含量低于对照组;血清中凋亡分子caspase-3、Bax的含量低于对照组,Bcl-2的含量高于对照组。结论:老年急性脑梗死患者在静脉溶栓基础上加入银杏内酯、依达拉奉联合治疗,可有效优化患者脑功能并减轻缺血再灌注过程中炎症反应及细胞凋亡所引起的损伤。

Objective:To explore the influence of ginkgolide combined with edaravone on the brain function of elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury.Methods:A total of126patients with acute cerebral infarction who were treated in Dazhou Central Hospital between February2016and May2017were divided into the control group(n=67)and ginkgolide group(n=59)according to different therapies.Control group received routine intravenous thrombolysis+edaravone therapy,and ginkgolide group received routine intravenous thrombolysis+edaravone+ginkgolide therapy.The differences in brain function and nerve ischemia reperfusion injury extent were compared between the two groups.Results:At T1and T2,serum nerve function indexes NT-proBNP and NSE levels of ginkgolide group were lower than those of control group whereas BDNF levels were higher than those of control group;serum inflammatory mediators MCP-1,NF-κB,CRP and TNF-αlevels were lower than those of control group;serum apoptosis molecules caspase-3and Bax levels were lower than those of control group whereas Bcl-2levels were higher than those of control group.Conclusion:Ginkgolide combined with edaravone therapy on the basis of intravenous thrombolysis can effectively optimize the brain function and alleviate the ischemia reperfusion injury caused by inflammatory response and apoptosisis in elderly patients with acute cerebral infarction.