银杏二萜内酯葡胺注射液治疗血管性帕金森综合征的疗效及对炎症因子的影响

The effect of ginkgo diterpene lactone meglumine injection in the treatment of vascular parkinsonism and its effect on inflammatory factors

目的探讨银杏二萜内酯葡胺注射液治疗血管性帕金森综合征(vascular parkinsonism,VP)患者的临床疗效及其对炎性因子的影响。方法前瞻性纳入2016年5月至2018年10月本院神经内科住院的亚急性血管性帕金森综合征患者作为研究对象,根据是否联用银杏二萜内酯葡胺注射液分为观察组和对照组。对照组予常规治疗(阿司匹林、他汀、多巴丝肼、控制危险因素等),观察组在对照组基础上联用银杏二萜内酯葡胺注射液治疗,疗程为14 d。采用帕金森病评定量表(UPDRS)、日常生活能力评分量表(ADL)、蒙特利尔认知评估量表(MoCA)评估临床疗效并观察两组患者不良反应发生情况;检测两组患者治疗前后血清炎性因子水平,包括超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、脂蛋白相关性磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)。结果共纳入血管性帕金森综合征患者78例,其中观察组40例,对照组38例。治疗后显示,观察组患者UPDRS评分低于对照组(P<0.05),MoCA、ADL评分均高于对照组[(25.90±1.88)分比(24.45±2.86)分,(74.00±5.90)分比(67.24±5.89)分](均P<0.05),观察组患者血清hs-CRP和Lp-PLA2水平均低于对照组[(5.13±1.70)mg/L比(6.27±1.89)mg/L,(175.00±14.37)μg/L比(198.50±26.92)μg/L](均P<0.05)。两组患者均未出现严重不良反应。结论银杏二萜内酯葡胺注射液可改善亚急性VP患者的症状并有效减轻VP患者的炎性反应,且安全性高。

Objective To explore the clinical effect of ginkgo diterpene lactone meglumine injection in the treatment of vascular parkinsonism and its effect on inflammatory factors.Methods Patients with subacute vascular parkinsonism admitted to Department of Neurology of our hospital from May 2016 to October 2018 were divided into observation group and control group.The control group was treated with conventional therapy(aspirin,statins,doposazine,control of risk factors,etc.),and the observation group was treated with ginkgo diterpene lactone meglumine injection on the basis of conventional therapy for 14 days.The clinical efficacy was evaluated by unified Parkinson's disease rating scale(UPDRS),activities of daily life(ADL)rating scale,and Montreal cognitive assessment scale(MoCA),and the adverse reactions of the two groups were observed.Serum inflammatory factors including high-sensitivity C-reactive protein(hs-CRP)and lipoprotein associated phospholipase A2(Lp-PLA2)were measured before and after treatment.Results Seventy-eight patients with vascular parkinsonism were included,40 cases in the observation group and 38 cases in the control group.After treatment,the UPDRS score of the observation group was lower than that of the control group(P<0.05),and the MoCA and ADL scores were higher than those of the control group[(25.90±1.88)points vs.(24.45±2.86)points,(74.00±5.90)points vs.(67.24±5.89)points](both P<0.05).After treatment,serum hs-CRP and Lp-PLA2 levels in the observation group were lower than those in the control group[(5.13±1.70)mg/L vs.(6.27±1.89)mg/L,(175.00±14.37)μg/L vs.(198.50±26.92)μg/L](both P<0.05).No serious adverse reactions occurred in both groups.Conclusion Ginkgo diterpene lactone meglumine injection can improve the symptoms of subacute vascular parkinsonism patients and effectively reduce the inflammatory response,with high safety.