银杏内酯注射液联合阿替普酶治疗急性脑梗死的临床疗效及其对血清抗氧化因子水平的影响

Clinical efficacy of Ginkgolide Injection combined with alteplase in treatment of acute cerebral infarction and its effect on serum levels of antioxidant factors

目的观察银杏内酯注射液联合阿替普酶治疗急性脑梗死的疗效及其对血清抗氧化因子水平的影响。方法选择2017年5月—2019年4月河南大学淮河医院收治的90例急性脑梗死患者作为研究对象,按随机数字表将患者分为对照组和观察组,每组各45例。对照组患者应用0.9 mg/kg注射用阿替普酶静脉溶栓治疗,先将阿替普酶溶于生理盐水配成1 mg/mL的溶液,然后在60 s内将10%的混合液静脉推注,再将余下的混合液在60 min内静脉滴注。观察组患者在对照组用药的基础上静脉滴注银杏内酯注射液,10 mL加入到250 mL生理盐水中,1次/d,连续用药14 d。观察两组患者的临床疗效,同时比较两组治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分、Rankin量表(mRS评分)、血清脂蛋白磷脂酶A2(LpPLA2)、神经元特异性烯醇化酶(NSE)、神经胶质纤维酸性蛋白(GFAP)、超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、内皮素-1(ET-1)水平。结果治疗后,对照组和观察组总有效率分别为46.7%和68.9%,两组比较差异存在统计学意义(P<0.05)。治疗后,两组患者NIHSS评分、mRS评分均显著降低(P<0.05);且观察组NIHSS评分、mRS评分显著低于对照组(P<0.05)。治疗后,两组患者Lp-PLA2、NSE、GFAP水平均显著降低(P<0.05),且观察组Lp-PLA2、NSE、GFAP水平显著低于对照组(P<0.05)。治疗后,两组患者的血清VEGF、ET-1、TNF-α水平均显著降低(P<0.05);且观察组血清VEGF、ET-1、TNF-α水平显著低于对照组(P<0.05)。结论对急性脑梗死患者采用银杏内酯注射液联合阿替普酶治疗,不仅可以显著减轻患者的神经功能缺损,提高近期疗效,而且具有提高机体抗氧化抗炎能力的作用,值得临床上进一步研究应用。

Objective To observe the effect of Ginkgolide Injection combined with alteplase in treatment of acute cerebral infarction and its effect on serum antioxidant factor level.Methods A total of 90 patients with acute cerebral infarction admitted to Huaihe Hospital of Henan University from May 2017 to April 2019 were selected as the research subjects.According to the random number table,the patients were divided into control group and observation group,with 45 patients in each group.Patients in the control group were received intravenous thrombolysis with 0.9 mg/kg Alteplase for Injection.Alteplase for Injection was dissolved in normal saline to form 1 mg/mL solution,then 10% of the mixed solution was intravenously injected within 60 s,and the remaining mixed solution was intravenously drip within 60 min.Patients in the observation group was intravenously injected with Ginkgolide Injection on the basis of control group,10 mL was added into 250 mL normal saline,once daily,treated for 14 d.To observe the clinical efficacy of two groups,and NIHSS score,mRS score,the levels of Lp-PLA2,NSE,GFAP,SOD,MDA,NO,VEGF,TNF-α,and ET-1 before and after treatment were compared.Results After treatment,the total effective rate of the control group and the observation group was 46.7% and 68.9%,respectively,and the difference between two groups was statistically significant(P<0.05).After treatment,NIHSS score and MRS score in two groups were significantly decreased(P<0.05),the NIHSS score and mRS score in observation group were significantly lower than those in control group(P<0.05).After treatment,the levels of Lp-PLA2,NSE,and GFAP in two groups were significantly decreased(P<0.05),and the levels of Lp-PLA2,NSE,and GFAP in observation group were significantly lower than those in control group(P<0.05).After treatment,the levels of serum VEGF,ET-1 and TNF-α in two groups were significantly decreased(P<0.05),the serum levels of VEGF,ET-1,and TNF-α in observation group were significantly lower than those in control group(P<0.05).Conclusion Ginkgolide Injection combined with alteplase in treatment of patients with acute cerebral infarction can not only significantly reduce the neurological function deficit of patients,improve the short-term efficacy,but also improve the body’s antioxidant and anti-inflammatory ability,which is worthy of further clinical research and application.