目的 探讨丁苯酞联合银杏叶提取物注射液治疗大面积脑梗死的临床疗效。方法 选取2012年6月—2015年6月于威海市中心医院神经内科住院的大面积脑梗死患者130例为研究对象，所有患者按就诊时间先后顺序随机分为对照组和治疗组，每组各65例。对照组静脉滴注银杏叶提取物注射液，70 mg加入到生理盐水250 mL，1次/d，连续使用21 d。治疗组在对照组基础上静脉滴注丁苯酞氯化钠注射液，100 mL/次，2次/d，连续使用14 d，然后改为口服丁苯酞软胶囊，0.2 g/次，3次/d，连续使用7 d。观察两组的临床疗效，比较两组的美国国立卫生研究院卒中量表（NIHSS）评分、日常生活能力量表（ADL）评分和血浆脂蛋白相关性磷脂酶A2（LP-PLA2）水平。结果 治疗后，对照组和治疗组的总有效率分别为73.85%、93.85%，两组比较差异有统计学意义（P<0.05）。治疗后，两组NIHSS评分均显著降低，ADL评分均显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的改善程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗10、21 d后，两组血浆LP-PLA2水平均显著下降，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组LP-PLA2水平明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 丁苯酞联合银杏叶提取物注射液治疗大面积脑梗死具有较好的疗效，可改善神经功能缺损和日常生活活动能力，调节血浆LP-PLA2水平，安全性较好，具有一定的临床推广应用价值。

Objective To investigate the effect of butyphthalide combined with Extract of Ginkgo Biloba Leaves Injection in treatment of large area cerebral infarction. Methods Patients (130 cases) with large area cerebral infarction in Weihai Central Hospital from June 2012 to June 2015 were randomly divided into control and treatment groups, and each group had 65 cases. Patients in the control group were iv administered with Extract of Ginkgo Biloba Leaves Injection, 70 mg added into normal saline 250 mL, once daily, treated for 21 d. Patients in the treatment group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of the control group, 100 mL/time, twice daily. After treatment for 14 d, Butylphthalide Soft Capsules before and after treatment were then used for 7 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, ADL scores, and plasma LP-PLA2 level were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.85% and 93.85%, respectively, and there was difference between two groups (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but the ADL scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment for 10 and 21 d, the plasma LP-PLA2 levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Butyphthalide combined with Extract of Ginkgo Biloba Leaves Injection has clinical curative effect in treatment of large area cerebral infarction, can improve neurological deficits and activities of daily living, and regulate the plasma LP-PLA2 level, with good safety, which has a certain clinical application value.