目的 观察银杏达莫注射液联合丁苯肽治疗老年急性脑梗死的临床疗效及其安全性。方法 选取2013年9月—2014年12月天津市环湖医院收治的老年急性脑梗死患者74例, 随机分为对照组与治疗组, 每组各37例。在常规治疗基础上, 对照组静脉滴注丁苯酞氯化钠注射液, 100 mL/次, 1次/d。治疗组在对照组的基础上静脉点滴银杏达莫注射液20 mL加入生理盐水500 mL, 1次/d。两组均连续治疗14 d。观察两组的临床疗效, 同时比较两组治疗前后神经功能缺损评分(NIHSS)、日常生活活动能力(ADL)评分、血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、组织纤溶酶原激活物(t-PA)、血栓调节蛋白(TM)、组织纤溶酶原激活物抑制物(PAI-1)等指标的变化。结果 治疗后, 对照组和治疗组的总有效率分别为89.19%、94.59%, 两组总有效率比较差异有统计学意义(P<0.05)。治疗后, 两组患者NO、SOD、t-PA、ADL评分均较同组治疗前显著升高, MDA、TM、PAI-1、NIHSS评分、CRP、TNF-α、IL-6较同组治疗前显著降低, 同组治疗前后差异有统计学意义(P<0.05);且治疗后治疗组这些观察指标的改善程度优于对照组, 两组比较差异有统计学意义(P<0.05)。结论 银杏达莫注射液联合丁苯肽治疗老年急性脑梗死具有较好的临床疗效, 能显著改善脑梗死患者的神经和行为功能, 减轻炎症反应, 调节血浆纤溶系统功能, 清除自由基及提高抗氧化酶活性。

Objective To observe the efficacy and safety of Ginkgo Leaf Extract and Dipyridamole Injection combined with butylphthalide in treatment of elderly acute cerebral infarction. Methods Patients (74 cases) with elderly acute cerebral infarction in Tianjin Huanhu Hospital from September 2013 to December 2014 were randomly divided into control and treatment groups, and each group had 37 cases. The patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of conventional treatment, 100 mL/time, once daily. The patients in the treatment group were iv administered with Ginkgo Leaf Extract and Dipyridamole Injection on the basis of control group, 20 mL dissolved in physiological saline 500 mL, once daily. Two groups were treated for 14 d. After treatment, the efficacy was evaluated, and the changes of National Institute of Health stroke scale (NIHSS), activities of daily living (ADL), serum C reaction protein (CRP), TNF-α, IL-6, superoxide dismutase (SOD), Malondialdehyde (MDA), NO, t-PA, thrombomodulin (TM), and PAI-1 in two groups were compared. Results The efficacies in the control and treatment groups were 89.19% and 94.59%, respectively, and there were differences between two groups (P < 0.05). After treatment, NO, SOD, t-PA, and ADL scores in two groups were significantly increased, and MDA, TM, PAI-1, NIHSS score, CRP, TNF-α, and IL-6 were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusion Ginkgo Leaf Extract and Dipyridamole Injection combined with butylphthalide has good clinical efficacy in treatment of elderly acute cerebral infarction, and can notably improve neurological and behavioral functions, while can significantly reduce inflammatory response and regulate plasma fibrinolytic system, which can remove free radicals and improve the activity of antioxidant enzymes.