银杏二萜内酯葡胺注射液联合脑苷肌肽治疗急性脑梗死效果及对血清S100B、MMP-9的影响

Curative Effect of Ginkgo Diterpene Lactone Meglumine Injection Combined with Cerebroside Carnosine on Acute Cerebral Infarction and Its Influences on Serum S100B and MMP-9

目的:探讨银杏二萜内酯葡胺注射液(DGMI)联合脑苷肌肽治疗急性脑梗死效果及对血清钙结合蛋白S100B、基质金属蛋白酶-9(MMP-9)的影响。方法:选取2019年1月-2021年1月在葫芦岛市中心医院确诊的120例急性脑梗死患者,将其随机分为观察组和对照组,每组60例。对照组采用DGMI治疗,观察组采用DGMI联合脑苷肌肽治疗,均持续治疗2周。分别于治疗前后,采用美国国立卫生研究院卒中量表(NIHSS)评估急性脑梗死患者神经功能缺损,采用日常生活能力量表(ADL)评估两组患者日常生活能力,使用酶联免疫吸附法(ELISA)测定两组患者血清中MMP-9、S100B、血管性血友病因子(vWF)、血小板膜蛋白-140(GMP-140)和凝血酶原片段(F1+2)的水平,采用凝血酶法测定血浆纤维蛋白原(Fg)水平。记录两组治疗期间的不良反应发生情况。结果:观察组治疗总有效率为96.67%,高于对照组的85.00%(P<0.05);治疗后,观察组患者NIHSS评分下降、ADL评分上升,变化均比对照组更明显(P<0.05);观察组患者血清中S100B、MMP-9表达水平均明显低于对照组(P<0.05);观察组血浆凝血指标vWF、GMP-140、Fg和F1+2水平明显均低于对照组(P<0.05);观察组治疗期间的不良反应发生率为6.67 %,低于对照组的23.33%(P<0.05)。结论:DGMI联合脑苷肌肽治疗可以明显修复患者神经功能缺损,提高患者生活自理能力,降低患者血清S100B,MMP-9和血浆vWF、GMP-140、Fg和F1+2水平,提高急性脑梗死患者的临床疗效。

Objective:To explore the curative effect of Ginkgo Diterpene Lactone Meglumine Injection combined with Cerebroside Carnosine on acute cerebral infarction and its influences on serum calcium-binding protein S100B and matrix metalloproteinase-9 (MMP-9).Method:A total of 120 patients confirmed with acute cerebral infarction in Huludao Central Hospital were enrolled between January 2019 and January 2021.They were randomly divided into observation group and control group,60 cases in each group.The control group was treated with Ginkgo Diterpene Lactone Meglumine Injection,while observation group was treated with Ginkgo Diterpene Lactone Meglumine Injection combined with Cerebroside Carnosine.All patients were treated for 2 weeks.Before and after treatment,neurological impairment of acute cerebral infarction patients was evaluated by national institutes of health stroke scale (NIHSS).The activities of daily living were assessed by activity of daily living scale (ADL).The levels of serum MMP-9,S100B,von willebrand factor (vWF),platelet membrane protein-140 (GMP-140) and prothrombin fragment (F1+2) were detected by enzyme-linked immunosorbent assay (ELISA).Plasma fibrinogen (Fg) level was detected by thrombin method.The occurrence of adverse reactions during treatment in both groups was recorded.Result:The total effective rate in observation group was 96.67%,higher than 85.00% in control group (P<0.05).After treatment,NIHSS score was decreased,while ADL score was increased in observation group,and the above changes were more significant than those in control group (P<0.05).The expression levels of serum S100B and MMP-9 in observation group were significantly lower than those in control group (P<0.05).The levels of plasma vWF,GMP-140,Fg and F1+2 in observation group were significantly lower than those in control group (P<0.05).The incidence of adverse reactions in the observation group was 6.67%,lower than 23.33% in the control group (P<0.05).Conclusion:Ginkgo Diterpene Lactone Meglumine Injection combined with Cerebroside Carnosine can significantly repair neurological impairment,improve self-care ability,reduce levels of serum S100B and MMP-9 and plasma vWF,GMP-140,Fg and F1+2,and improve clinical curative effect on patients with acute cerebral infarction.