银杏内酯注射液联合高压氧对急性缺血性脑卒中患者神经功能及血栓素血小板活化因子水平的影响

Effect of ginkgolide injection combined with hyperbaric oxygen on neurological function and TXB2 and PAF levels in patients with acute ischemic stroke

目的探讨银杏内酯注射液联合高压氧对急性缺血性脑卒中(AIS)患者神经功能及血栓素(TXB2)和血小板活化因子(PAF)水平的影响。方法选取2015年7月至2017年4月舞钢公司总医院神经内科收治的AIS患者86例,依据随机数字表法将患者分为观察组和对照组,每组各43例。在常规对症治疗基础上,对照组予以高压氧治疗,观察组予以高压氧+银杏内酯注射液治疗,两组患者均规律治疗14 d。对比两组患者不良反应发生率、治疗效果及治疗前后神经功能(NIHSS)、认知功能(MMSE)、日常生活能力(Barthel)评分及血清TXB2水平、血浆PAF水平。结果①神经功能:观察组治疗后NIHSS评分降低程度高于对照组,差异有统计学意义(P <0. 05);②治疗效果:观察组治疗总有效率93. 02%高于对照组76. 74%,差异有统计学意义(P <0. 05);③血清TXB2水平、血浆PAF水平:治疗后,观察组血清TXB2、血浆PAF水平降低程度高于对照组,差异有统计学意义(P <0. 05);④MMSE、Barthel评分:治疗后,观察组MMSE、Barthel评分高于对照组,差异有统计学意义(P <0. 05);⑤不良反应率:观察组不良反应率13. 95%与对照组25. 58%比较,差异无统计学意义(P> 0. 05)。结论在高压氧治疗基础上,联合采用银杏内酯注射液治疗AIS,可明显降低患者血清TXB2水平、血浆PAF水平,改善神经功能和认知功能,有效提高患者日常生活能力,且安全性高,值得临床推广。

Objective To investigate the effects of ginkgolide injection combined with hyperbaric oxygen on neurological function and thromboxane (TXB2) and platelet activating factor (PAF) levels in patients with acute ischemic stroke (AIS). Methods Eighty-six patients with AIS admitted to (Department of Neurocology, Wugang General Hospital from July 2015 to April 2017 were enrolled. The patients were divided into observation group (43 cases) and control group (43 cases) according to the random number table method. On the basis of conventional symptomatic treatment, control group was treated with hyperbaric oxygen, and observation group with hyperbaric oxygen + ginkgolides injection. Both groups were treated for 14 days. The adverse reaction rate, treatment effect and neurological function (NIHSS), cognitive function (MMSE), daily living ability (Barthel) score, serum TXB2 level and plasma PAF level were compared between the two groups. Results (1) Neurological function: After the treatment, NIHSS score of observation group was lower than that of control group, and the difference was statistically significant ( P <0.05).(2) The therapeutic effect: the total effective rate of observation group was 93.02%(40/43), which was higher than the 76.74% of control, and the difference was statistically significant (33/43)( P <0.05);(3) serum TXB2 level, plasma PAF level: after the end of the course, serum TXB2 level and plasma PAF level of observation group were lower than those of control group, and the difference was statistically significant ( P <0.05);(4) MMSE, Barthel score: After treatment, MMSE and Barthel scores of observation group were higher than those of control group, and the difference was statistically significant ( P <0.05).(5) Adverse reaction rate: the adverse reaction rate of observation group was 13.95%(6/43) and the control group was 25.58%(11/ 43). The difference was not statistically significant ( P >0.05). Conclusions On the basis of hyperbaric oxygen therapy, the combination of ginkgolide injection in treatment of AIS with high safety can significantly reduce serum TXB2 level and plasma PAF level, markedly improve neurological function and cognitive function, and effectively improve daily living ability of patients, and the effect is more remarkable. It is worth clinical promotion in clinical treatment.