目的 探讨银杏二萜内酯葡胺联合替罗非班治疗急性脑梗死的临床疗效。方法 选取2022年1月—2023年12月在河南科技大学第一附属医院治疗的急性脑梗死患者94例，随机分为对照组和治疗组，每组各47例。对照组静脉滴注盐酸替罗非班注射液，前30 min以0.4μg/(kg·min)速度滴注，随后改成0.1μg/(kg·min)维持72 h。治疗组患者在对照组基础上静脉滴注银杏二萜内酯葡胺注射液，1次/d，每次取5 mL溶于250 mL生理盐水。两组患者给予持续14 d的治疗。观察两组患者临床疗效，比较治疗前后两组患者Barthel指数评分、美国国立卫生研究院卒中量表（NIHSS）评分和脑卒中改良Rankin量表（mR S）评分，及血清重组人泛素羧基末端水解酶L1(UCH-L1)、可溶性凝集素样氧化低密度脂蛋白受体1(Slox-1)和同型半胱氨酸（Hcy）水平。结果 治疗后，对照组和治疗组临床总有效率分别为78.72%和93.61%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者Barthel指数均明显提高，而NIHSS与mR S分值均大幅下降（P<0.05），且治疗组得分优于对照组（P<0.05）。治疗后，两组患者血清UCH-L1、Slox-1及Hcy水平均显著下降（P<0.05），且治疗组数值下降程度高于对照组（P<0.05）。结论 银杏二萜内酯葡胺联合替罗非班治疗急性脑梗死疗效显著，能够明显缓解神经功能缺失并提高日常生活自理能力。

Objective Investigate clinical efficacy of ginkgo diterpene lactone meglumine combined with tirofiban in treatment of acute cerebral infarction. Methods Patients（94 cases） with acute cerebral infarction in the First Affiliated Hospital of Henan University of Science and Technology from January 2022 to December 2023 were randomly divided into control and treatment group,and each group had 47 cases. Patients in the control group were iv administered with Tirofiban Hydrochloride Injection, 0.4μg/（kg·min） for the first 30 min, then adjusted to 0.1 μg/（kg·min） for 72 h. Patients in the treatment group were iv administered with Ginkgo Diterpene Lactone Meglumine Injection, 5 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the scores of Barthel, NIHSS, and mRS, and the serum UCHL1, Slox-1 and Hcy levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 78.72% and 93.61%, respectively, and the difference between the two groups was statistically significant（P＜0.05）. After treatment, the Barthel index in two groups was significantly increased, while the NIHSS and mRS scores were significantly decreased（P＜0.05）, and the score of the treatment group was better than that of the control group（P＜0.05）. After treatment, the serum UCH-L1, Slox-1 and Hcy levels in two groups were significantly decreased（P＜0.05）, and the decrease in the treatment group was higher than that in the control group（P＜0.05）. Conclusion Ginkgo diterpene lactone meglumine combined with tirofiban exhibits pronounced efficacy in treatment of acute cerebral infarction, significantly ameliorating the patients’ neurological deficiency and self-care abilities.

R971

洛阳市市级医疗卫生科技计划项目(1920024A)