银杏叶片联合氯吡格雷治疗伴2型糖尿病急性脑梗死患者的效果和安全性

Effect and Safety of Ginkgo Biloba Leaf combined with Clopidogrel in the Treatment of Acute Cerebral Infarction Patients with Type 2 Diabetes Mellitus

目的 探讨银杏叶片联合氯吡格雷治疗伴2型糖尿病急性脑梗死患者的效果和安全性。方法 选取2019年1月至2022年12月西安交通大学医院收治的伴2型糖尿病急性脑梗死患者100例作为研究对象,使用随机数字表法分为对照组与观察组,每组50例。对照组采取营养支持、调节水电解质紊乱、神经保护、改善循环、稳定斑块、控制血脂血压等常规治疗,并口服对应降糖药、拜阿司匹林,静脉滴注奥扎格雷钠。观察组在对照组基础上增加银杏叶片联合氯吡格雷口服治疗。比较两组患者临床疗效、不良反应情况、血清生化指标、脑血流灌注以及神经功能指标变化情况。结果 两组患者均无严重不良反应发生,且发生率比较差异无统计学意义(P>0.05),观察组治疗有效率96.00%明显高于对照组80.00%(P<0.05);两组患者治疗前空腹血糖(FPG)、餐后2 h血糖(2hPBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)比较差异无统计学意义(P>0.05),治疗后两组患者相关血清生化指标均降低,且观察组更低,差异有统计学意义(P<0.05);两组患者治疗前脑血容量(CBV)和脑血流量(CBF)比较差异无统计学意义(P>0.05),治疗后两组患者CBV、CBF升高,且观察组高于对照组,差异有统计学意义(P<0.05);两组患者治疗前神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)比较差异无统计学意义(P>0.05),治疗后两组患者NSE、NGF降低,且观察组更低,两组BDNF升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 银杏叶片联合氯吡格雷可改善伴2型糖尿病急性脑梗死患者的治疗效果,安全性较高,同时能进一步降低患者血糖、血脂水平,改善脑血流灌注,促进患者神经功能恢复。

Objective To explore the efficacy and safety of ginkgo biloba leaf combined with clopidogrel in the treatment of acute cerebral infarction patients with type 2 diabetes.Methods A total of 100 patients with type 2 diabetes with acute cerebral infarction admitted to Xi 'an Jiaotong University Hospital from January 2019 to December 2022 were selected as the study objects,and were divided into control group and observation group using random number table method,with 50 cases in each group.The control group was given routine treatment such as nutritional support,regulation of water and electrolyte disorders,neuroprotection,improvement of circulation,stabilization of plaque,control of blood lipids,blood pressure,and oral administration of corresponding hypoglycemic drugs,aspirin,and intravenous infusion of sodium ozagrel.On the basis of the control group,the observation group added ginkgo biloba leaf combined with clopidogrel oral treatment.The clinical efficacy,adverse reactions,serum biochemical indexes,cerebral blood perfusion and nerve function indexes of the two groups were compared.Results No serious adverse reactions occurred between the two groups,and the incidence rate was not statistically significant(P>0.05).The effective rate of treatment in the observation group was 96.00%,which was significantly higher than that in the control group 80.00%(P<0.05).There was no significant difference in fasting blood glucose(FPG),2h postmeal blood glucose(2hPBG),total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) between the two groups before treatment(P>0.05).After treatment,the serum biochemical indices were all decreased between the two groups,and the observation group was lower.The difference was statistically significant(P<0.05).There was no statistical significance in cerebral blood volume(CBV) and cerebral blood flow(CBF) between the two groups before treatment(P>0.05).After treatment,the CBV and CBF of the two groups were increased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).There was no significant difference in neuronal specific enolase(NSE),brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF) between the two groups before treatment(P>0.05).After treatment,NSE and NGF decreased between the two groups,and the observation group was lower,while BDNF increased between the two groups,and the observation group was higher than the control group.The difference was statistically significant(P<0.05).Conclusion Ginkgo biloba leaf combined with clopidogrel can improve the treatment effect of acute cerebral infarction patients with type 2 diabetes mellitus,with high safety,and can further reduce the blood sugar and lipid levels of patients,increase the blood flow perfusion,and promote the recovery of neurological function of patients.