银杏达莫联合脑苷肌肽治疗对脑梗死患者的疗效观察

Therapeutic effect of Yinxingdamo combined with cerebellin on patients with cerebral infarction

目的:观察银杏达莫联合脑苷脑苷肌肽治疗对急性脑梗死患者疗效,并探讨其相关机制。方法:选择2016年1月至2017年12月接诊的100例急性脑梗死患者为研究对象,根据抽签法将患者分为常规组和观察组,各50例。常规组采用单纯脑苷激肽治疗,观察组采用脑苷激肽联合银杏达莫注射液治疗。比较两组患者治疗前后的神经功能、炎症因子、血液流变学及凝血功能指标的变化。结果:治疗前,两组患者神经功能、炎症因子、血液流变学及凝血功能指标均无显著差异(P>0.05)。治疗后,两组患者胱抑素C(cystatin C,Cys-c)、基质金属蛋白酶-9(matrix metalloprotein-9,MMP-9)和同型半胱胺酸(homocysteine,Hcy),血浆比黏度、全血比黏度、HCT和Arbc水平,组织因子(Tissue factor,TF)和组织因子/组织因子途径抑制物(Tissue factor/Tissue factor pathway inhibitor,TF/TFPI)水平和美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分均明显降低,神经生长因子(nerve growth factor,NGF)和脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)和组织因子途径抑制物(tissue factor pathway inhibitor,TFPI)水平明显升高(均P<0.05)。观察组NIHSS评分、Cys-C、MMP-9、Hcy,血浆比黏度、全血比黏度、红细胞比容(hematocrit value,HCT)和红细胞聚集指数(red cell aggregation index,Arbc)水平,TF和TF/TFPI水平均低于常规组,NGF、BNDF和TFPI水平高于常规组(P<0.05)。结论:银杏达莫联合脑苷肌肽治疗效果显著,可显著缓解炎症应激反应,改善神经缺损情况及高凝状态,具有较高的临床价值。

OBJECTIVE To observe the efficacy of Yinxingdamo combined with cerebellin in patients with acute cerebral infarction and to explore its related mechanisms. METHODS A total of 100 patients with acute cerebral infarction admitted from January 2016 to December 2017 were selected as the study subjects. According to the lottery, the patients were divided into the conventional group and the observation group, with 50 cases in each group. The conventional group was treated with butylphthalide alone, and the observation group was treated with butylphthalide plus ginkgo-damo injection. The changes of neurological function, inflammatory factors, Hemorheology and coagulation function before and after treatment were compared between the two groups. RESULTS Before treatment, there were no significant differences in neurological function, inflammatory factors, Hemorheology and coagulation function between the two groups(P>0.05). After treatment, the levels of cystatin C(Cys-c), matrix metalloprotein-9(MMP-9), cystatin C(Cys-c), homocysteine(Hcy), plasma specific viscosity, whole blood specific viscosity, hematocrit value(HCT) and red cell aggregation index(Arbc), tissue factor(TF) and Tissue factor/Tissue factor pathway inhibitor(TF/TFPI) levels as well as National Institute of Health Stroke Scale(NIHSS) scores were significantly decreased, while the levels of nerve growth factor(NGF), brain-derived neurotrophic factor(BNDF) and tissue factor pathway inhibitor(TFPI) were significantly increased in both groups(all P<0.05). The NIHSS score, Cys-C, MMP-9, Hcy, plasma specific viscosity, whole blood specific viscosity, HCT, Arbc levels, TF and TF/TFPI levels in the observation group were lower than those in the conventional group, while the levels of NGF, BNDF and TFPI were higher than those in the conventional group(all P<0.05). CONCLUSION Ginkgo biloba combined with cerebroside kinin has demonstrated a significant therapeutic effect, and it can significantly alleviate inflammatory stress response, improve neurological deficit and hypercoagulable state, which has high clinical value.