高压氧联合银杏二萜内酯对中青年急性缺血性脑卒中患者脑血流及ESM-1、LP-PLA2、PTX-3水平的影响

Effects of Hyperbaric oxygen Combined with Ginkgo diterpene Lactone on Cerebral Blood Flow and Levels of ESM-1,LP-PLA2 and PTX-3 in young and Middle-aged Patients with Acute Ischemic Stroke

目的:研究高压氧(HBO)联合银杏二萜内酯对中青年急性缺血性脑卒中(AIS)患者脑血流及ESM-1、LP-PLA2、PTX-3水平的影响。方法:选取2019年6月—2021年8月中青年AIS患者92例,随机分为联合组和对照组各46例。2组均给予常规治疗,对照组在常规治疗基础上加以HBO治疗,联合组在对照组基础上予以银杏二萜内酯治疗。7 d为1个疗程,治疗2个疗程后比较2组临床疗效、血液最大峰值流速(Vmax)、内皮细胞特异性分子-1(ESM-1)、日常生活能力(Barthel)、血管搏动指数(PI)、神经功能(NIHSS)、血液平均流速(Vmean)、脂蛋白磷脂酶A2(Lp-PLA2)、血管阻力指数(RI)、认知功能(MMSE)、穿透素-3(PTX-3)水平及不良反应发生率。结果:联合组临床有效率91.30%高于对照组71.74%;联合组NIHSS评分、RI、PI水平较对照组降低,MMSE、Barthel评分及Vmax、Vmean水平较对照组升高;2组血清ESM-1、Lp-PLA2、PTX-3较入院时降低,且联合组低于对照组,差异均有统计学意义。联合组不良反应发生率13.04%与对照组21.74%相比,无显著差异。结论:HBO联合银杏二萜内酯治疗AIS,可延缓炎性反应,改善血流动力学,减轻神经细胞损伤,恢复患者认知及生活能力,疗效确切。

Objective:To study the effects of hyperbaric oxygen (HBO) combined with ginkgo diterpene lactones on cerebral blood flow and levels of ESM-1,LP PLA2,and PTX-3 in young and middle-aged patients with acute ischemic stroke (AIS).Methods:A total of 92 young and middle-aged AIS patients from June 2019 to August 2021 were selected,and randomly divided into the combination group and the control group,46 cases each.Both groups were given conventional treatment,the control group was given HBO treatment on the basis of conventional treatment,and the combination group was given ginkgo diterpene lactone treatment on the basis of the control group.7 days was a course of treatment.After 2 courses of treatment,the clinical efficacy,maximum peak blood velocity (Vmax),endothelial cell-specific molecule-1 (ESM-1),ability of daily living (Barthel),vascular pulsatility index (PI),neurological function (NIHSS),mean blood flow velocity (Vmean),lipoprotein phospholipase A2 (Lp-PLA2),vascular resistance index (RI),cognitive function (MMSE),penetrantin-3 (PTX-3) levels and the incidence of adverse reactions.Results:The clinical effective rate of the combination group was 91.30%higher than that of the control group (71.74%);the NIHSS score,RI,and PI levels of the combination group were lower than those of the control group,and the MMSE,Barthel scores,Vmax,and Vmean levels were higher than those of the control group;the serum ESM-1.The levels of Lp-PLA2 and PTX-3 were lower than those at admission,and the combination group was lower than the control group,and the differences were statistically significant.The incidence of adverse reactions in the combination group was 13.04%,compared with 21.74%in the control group,there was no significant difference.Conclusion:HBO combined with ginkgo diterpene lactones in the treatment of AIS can delay the inflammatory response,improve hemodynamics,reduce nerve cell damage,and restore the patient’s cognition and living ability.The curative effect is definite.