[关键词]
[摘要]
目的 探讨银杏达莫注射液联合注射用阿替普酶治疗急性脑梗死患者的临床疗效。方法 选择2018年6月—2020年6月上海市浦东新区周浦医院收治的90例急性脑梗死患者作为研究对象,将全部患者随机分为治疗组和对照组,每组各45例。对照组静脉滴注注射用阿替普酶,0.9 mg/kg溶于100 mL生理盐水中,最大给药剂量不超过90 mg;1 min内注射总剂量的10%,剩余90%在1 h内注射完成。治疗组在对照组治疗的基础上静脉滴注银杏达莫注射液,10 mL加入生理盐水250 mL中,1次/d,连续治疗7 d。观察两组患者的临床疗效,比较两组治疗前后神经功能、脑血流动力学指标和氧化应激指标。结果 治疗后,治疗组患者的总有效率(95.6%)显著高于对照组的总有效率(82.2%),两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的国立卫生研究院卒中量表(NIHSS)评分较治疗前显著降低(P<0.05);且治疗后治疗组的NIHSS评分显著低于对照组(P<0.05)。治疗后,两组患者的平均颈动脉血流量(Q均值)、平均血流速度(V均值)、外周阻力显著高于治疗前,特征阻抗显著低于治疗前(P<0.05);且治疗后治疗组Q均值、V均值、外周阻力显著高于对照组,特征阻抗显著低于对照组(P<0.05)。治疗后,两组的氧化蛋白产物(AOPP)、丙二醛(MDA)水平显著低于治疗前,超氧化物歧化酶(SOD)水平显著高于治疗前(P<0.05);且治疗组AOPP、MDA水平显著低于对照组,SOD水平显著高于对照组(P<0.05)。结论 银杏达莫注射液联合注射用阿替普酶治疗急性脑梗死患者具有较好的临床疗效,能显著改善神经功能和脑血流动力,降低氧化应激反应。
[Key word]
[Abstract]
Objective To study the clinical efficacy of Ginkgo Leaf Extract and Dipyridamole Injection combined with Alteplase for injection in treatment of acute cerebral infarction. Methods Patients (90 cases) with acute cerebral infarction in Shanghai Pudong New District Zhoupu Hospital from June 2018 to June 2020 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were iv administered with Alteplase for injection, 0.6 mg/kg added into normal saline 100 mL, the maximum dosage shall not exceed 60 mg, 10% of the total dose was injected within 1 min, and the remaining 90% was completed within 1 h. Patients in the treatment group were iv administered with Ginkgo Leaf Extract and Dipyridamole Injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily, treated for 7 d. After treatment, the clinical efficacies were evaluated, and neurological function, cerebral hemodynamic indexes, and oxidative stress indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group (95.6%) was significantly higher than that of the control group (82.2%), and the difference was statistically significant between two groups (P<0.05). After treatment, the NIHSS scores of two groups was significantly lower than that before treatment (P<0.05). After treatment, the NIHSS score of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, Qmeans, Vmeans, and peripheral resistance levels of two groups were significantly higher than those before treatment, but characteristic impedance was significantly lower than that before treatment (P<0.05). After treatment, the Qmeans, Vmeans, and peripheral resistance levels in the treatment group were significantly higher than those in the control group, but the characteristic impedance was significantly lower than that in the control group (P<0.05). After treatment, the levels of AOPP and MDA in two groups were significantly lower than those before treatment, but the levels of SOD in two groups were significantly higher than those before treatment (P<0.05). After treatment, the levels of AOPP and MDA in the treatment group were significantly lower than those in the control group, but the levels of SOD in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Ginkgo Leaf Extract and Dipyridamole Injection combined with Alteplase for injection can significantly improve neurological function and cerebral hemodynamics, and reduce oxidative stress in patients with acute cerebral infarction.
[中图分类号]
R971
[基金项目]
上海健康医学院附属周浦医院院级课题(ZPXM-2019B-05)