目的 探讨银杏内酯注射液联合吡拉西坦治疗急性脑梗死患者的临床疗效。方法 选取2020年1月—2020年12月于焦作市第二人民医院诊治的136例急性脑梗死患者，随机分为对照组和治疗组，每组各68例。对照组静脉滴注注射用吡拉西坦，4 g加入生理盐水250 mL，1次/d；治疗组在对照组基础上静脉滴注银杏内酯注射液，5支加入生理盐水250 mL，1次/d。两组患者均连续治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生研究院卒中量表（NIHSS）、功能独立性评价量表（FIM）和简式Fugl-Meyer（FMA）评分，炎症反应指标单核细胞趋化蛋白-1（MCP-1）、基质金属蛋白酶9（MMP-9）和高迁移率组蛋白1（HMGB1），神经细胞凋亡指标缺氧诱导因子-1α（HIF-1α）和S100钙结合蛋白β（S100β）水平，促血管新生和神经发生指标血管内皮生长因子（VEGF）和脑源性神经营养因子（BDNF）水平。结果 治疗后，对照组临床有效率为86.76%，明显低于治疗组的97.06%（P<0.05）；治疗后，两组NIHSS评分较治疗前均显著下降，而FMA、FIM评分显著提高（P<0.05），且治疗组患者各评分改善更显著（P<0.05）。治疗后，两组MCP-1、MMP-9、HMGB1水平均显著下降（P<0.05），且治疗组患者下降更明显（P<0.05）。治疗后，两组HIF-1α、S100β水平均显著下降（P<0.05），且治疗组下降更明显（P<0.05）。治疗后，两组VEGF、BDNF水平显著提高（P<0.05），且治疗组升高更明显（P<0.05）。结论 银杏内酯注射液联合吡拉西坦治疗急性脑梗死患者临床疗效较佳，可有效改善患者神经功能缺损程度，提高日常生活能力和运动能力，抑制炎症反应，减轻脑损伤，安全性高。

Objective To investigate the clinical efficacy of Ginkgolide Injection combined with piracetam in treatment of acute cerebral infarction. Methods Patients (136 cases) with acute cerebral infarction in the Second People's Hospital of Jiaozuo from January 2020 to December 2020 were randomly divided into control and treatment groups, and each group had 68 cases. Patients in the control group were iv administered with Piracetam for injection, 4 g added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Ginkgolide Injection on the basis of the control group, 5 g added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS, FIM and FMA scores, the inflammatory reaction indexes of MCP-1, MMP-9 and HMGB1, the level of neuronal apoptosis indexes of HIF-1α and S100β, the angiogenesis and neurogenesis indexes of VEGF and BDNF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the control group was 86.76%, which was significantly lower than 97.06% in the treatment group (P < 0.05). After treatment, the NIHSS scores in two groups were significantly lower than those before treatment, while the scores of FMA and FIM were significantly increased (P < 0.05), and these scores in the treatment group were improved more significantly (P < 0.05). After treatment, the levels of MCP-1, MMP-9, and HMGB1 in two groups were significantly decreased (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of HIF-1α and S100β in two groups were significantly decreased (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of VEGF and BDNF in two groups were significantly increased (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Ginkgolide Injection combined with piracetam has good clinical effect on treatment of acute cerebral infarction, can effectively improve the degree of neurological impairment, improve the ability of daily life and exercise, inhibit inflammatory reaction, reduce brain injury, and have high safety.

R971