银杏叶提取物注射液联合常规治疗对急性脑梗死后血管再生、侧支循环建立的影响

Effects of Ginkgo Biloba Extract Injection Combined with Conventional Treatment on Vascular Regeneration and Collateral Circulation After Cerebral Infarction

目的:探讨银杏叶提取物注射液联合常规治疗对急性脑梗死后血管再生、侧支循环建立的影响。方法:选取2018年3月至2021年12月该院收治的急性脑梗死患者80例,采用随机数字表法分为对照组和观察组,各40例。对照组患者根据指南予以常规治疗,观察组患者在对照组的基础上加用银杏叶提取物注射液治疗。治疗28 d后,观察两组患者血清血管内皮生长因子(VEGF)、血管生成素(Ang)和碱性成纤维细胞生长因子(bFGF)水平,美国介入和治疗神经放射学会/介入放射学会(ASITN/SIR)侧支循环分级、美国国立卫生院神经功能缺损评分(NIHSS)、蒙特利尔认知评估(MoCA)、简易智能精神状态检查(MMSE)和改良Rankin(mRS)评分,以及不良反应发生情况。结果:两组患者治疗后的血清VEGF、Ang和bFGF水平,MoCA、MMSE评分均较治疗前升高,ASITN/SIR侧支循环分级较治疗前改善,NIHSS评分均较治疗前降低,差异均有统计学意义(P<0.05)。观察组患者治疗后的血清VEGF[(52.31±11.59) pg/mL vs.(43.15±9.37) pg/mL]、Ang[(23.15±4.57) ng/mL vs.(19.35±3.78) ng/mL]和bFGF[(16.31±4.11) ng/L vs.(13.08±3.42) ng/L]水平,MoCA评分[(28.15±1.02)分vs.(25.34±2.69)分]、MMSE评分[(27.42±2.03)分vs.(24.43±3.72)分]明显高于对照组,ASITN/SIR侧支循环分级优于对照组,NIHSS评分[(8.12±2.03)分vs.(11.24±2.68)分]、mRS评分[(2.01±0.69)分vs.(3.75±0.85)分]低于对照组,差异均有统计学意义(P<0.05)。观察组、对照组患者不良反应发生率比较,差异无统计学意义[7.50%(3/40)vs. 10.00%(4/40),P>0.05]。结论:银杏叶提取物注射液可促使急性脑梗死血管再生和侧支循环建立,改善患者神经、认知功能以及预后。

OBJECTIVE: To probe into the effects of ginkgo biloba extract injection combined with conventional treatment on vascular regeneration and collateral circulation after cerebral infarction. METHODS: Totally 80 patients with acute cerebral infarction admitted into the hospital from Mar. 2018 to Dec. 2021 were extracted to be divided into the control group and observation group via the random number table method, with 40 cases in each group. The control group was given conventional treatment according to the guidelines, while the observation group received ginkgo biloba extract injection based on the control group. After treatment of 28 d, the serum levels of vascular endothelial growth factor(VEGF), angiopoietin(Ang), basic fibroblast growth factor(bFGF), American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR) lateral circulation classification, National Institutes of Health Stroke Scale(NIHSS), Montreal cognitive assessment(MoCA), mini-mental state examination(MMSE), modified Rankin(mRS) score and adverse drug reactions were observed in both groups. RESULTS: After treatment, compared with before treatment, the serum levels of VEGF, Ang, bFGF, MOCA and MMSE scores increased, ASITN/SIR lateral circulation classification was improved, and NIHSS score decreased, with statistically significant differences(P<0.05). After treatment, the serum levels of VEGF [(52.31±11.59) pg/mL vs.(43.15±9.37) pg/mL], Ang [(23.15±4.57) ng/mL vs.(19.35±3.78) ng/mL], bFGF [(16.31±4.11) ng/L vs.(13.08±3.42) ng/L], MoCA [(28.15±1.02) points vs.(25.34±2.69) points] and MMSE [(27.42±2.03) points vs.(24.43±3.72) points] in the observation group were higher than those in the control group, the ASITN/SIR lateral circulation classification was better than that in the control group, the NIHSS score [(8.12±2.03) points vs.(11.24±2.68) points] and mRS score [(2.01±0.69) points vs.(3.75±0.85) points] were lower than those in the control group, with statistically significant differences(P<0.05). There was no significant difference in the incidence of adverse drug reactions between the observation group and the control group [7.50%(3/40) vs. 10.00%(4/40), P>0.05]. CONCLUSIONS: Ginkgo biloba extract injection can promote the regeneration of cerebral infarction and the establishment of collateral circulation, improve the neurological and cognitive function and prognosis of patients.