银杏二萜内酯葡胺联合依达拉奉右莰醇、丁苯酞注射液对超溶栓时间窗急性脑梗死的临床应用

Clinical Application of Diterpene Ginkgolides Meglumine Combined with Edaravone Dextracanthol and Butylphthalideinjection in Treating Acute Cerebral Infarction with Beyond Thrombolytic Time Window

目的:探究银杏二萜内酯葡胺注射液联合依达拉奉右莰醇、丁苯酞注射液对超溶栓时间窗急性脑梗死的临床应用。方法:收集我院神经内科2022年01月~2023年12月住院的120例超溶栓时间窗的急性脑梗死患者的病历资料,进行回顾性分析。按治疗方式不同分为60例对照组(依达拉奉右莰醇、丁苯酞注射液治疗)与60例研究组(银杏二萜内酯葡胺联合依达拉奉右莰醇、丁苯酞注射液治疗)。观察两组临床疗效及短期预后情况,并比较治疗前、后两组血液流变学指标、血清炎症因子指标(IL-6、CRP、NSE)、神经功能(NIHSS评分)及日常生活能力(MBI评分)。结果:治疗10天后,两组的红细胞比容、血浆粘度、全血高切粘度和IL-6、CRP、NSE指标较治疗前均有下降,且研究组下降幅度较对照组大(P<0.05);两组治疗后的NIHSS评分较治疗前亦有下降;两组治疗后10 d预后良好率相比无差异(P>0.05);30 d预后良好率,对照组低于研究组(P<0.05)。结论:银杏二萜内酯葡胺注射液联合依达拉奉右莰醇、丁苯酞注射液对超溶栓时间窗急性脑梗死的临床疗效良好。

Objective:The purpose of this study was to explore the clinical application of diterpene ginkgolides meglumine combined with edaravone dextracanthol and butylphthalide injection in treating acute cerebral infarction with beyond thrombolytic time window.Methods:The clinical data of 120 patients with acute cerebral infarction with beyond thrombolytic time window admitted to the Department of Neurology in Affiliated Hospital of Jiangnan University were retrospectively analyzed,and the patients were divided into control group and study group.The control group(60 cases)was treated with edaravone dextracanthol and butylphthalide injection,and the study group(60 cases)was added with diterpene ginkgolides meglumine.The hemorheology indexes,the peripheral blood inflammatory factors,neurological function(NIHSS score),daily living ability(MBI score).Results:After 10 days of treatment,the hematocrit,plasma viscosity and whole blood high shear viscosity decreased in both groups,and the decrease in the study group was greater than that in the control group(P<0.05).The levels of IL-6,CRP and NSE in both groups were also the same as above.The scores of NIHSS decreased in both groups after treatment.The rate of good prognosis was the same between the two groups 10 days after treatment(P>0.05),but the rate of good prognosis in the study group was higher than that in the control group at the 30th day after treatment(P<0.05).Conclusion:Diterpene ginkgolides meglumine combined with edaravone dextracanthol and butylphthalide injection has a good effect in the treatment of acute cerebral infarction with beyond thrombolytic time window,and has fewer adverse reactions.