目的 探讨银杏内酯注射液联合替格瑞洛治疗急性基底动脉闭塞性脑梗死的疗效。方法 纳入2022年8月—2024年8月沧州市人民医院神经内科收治的80例急性基底动脉闭塞性脑梗死患者，均接受支架取栓治疗。根据干预方案差异将病例分为对照组（n=40）和治疗组（n=40）。对照组口服替格瑞洛片，90 mg/次，1日2次。治疗组在对照组标准化治疗基础上联合应用银杏内酯注射液，每日10 mL与250 mL生理盐水混合后静脉滴注。两组干预周期均持续14 d。观察两组患者临床疗效，比较治疗前后两组患者巴塞尔指数（BI）评分、血管再通分级（MTICI）评分和美国国立卫生研究院卒中量表（NIHSS）评分，血清重组人泛素羧基末端水解酶L1（UCH-L1）、人成纤维细胞生长因子4（FGF4）和神经元PAS结构域蛋白4（NPASDP4）水平，及并发症情况。结果 疗效分析结果显示，治疗组总有效率85.00%，显著高于常规对照组的65.00%（P＜0.05）。神经功能恢复指标方面，两组Barthel指数与MTICI分级均呈现显著升高，而NIHSS评分均呈现显著降低，其中治疗组各指标改善幅度相较对照组更为突出（P＜0.05）。神经损伤相关生物标志物方面，治疗后，两组血清UCH-L1、FGF4和NPASDP4水平较治疗前显著降低（P＜0.05），且治疗组各指标水平明显低于对照组（P＜0.05）。治疗期间及疗程结束后1个月内对照组和治疗组患者并发症发生率分别为20.00%和5.00%，治疗组并发症发生率明显低于对照组（P＜0.05）。结论 银杏内酯注射液联合替格瑞洛治疗急性基底动脉闭塞性脑梗死血管再通效果显著，不仅能大幅改善患者神经功能缺损程度和自我护理能力，而且还能有效促进血清学相关指标恢复并降低并发症发生率。

Objective To evaluate the therapeutic efficacy of Ginkgolide Injection combined with Ticagrelor in treatment of acute basilar artery occlusive cerebral infarction. Methods A total of 80 patients with acute basilar occlusive cerebral infarction admitted to the Department of Neurology of Cangzhou People's Hospital from August 2022 to August 2024 were included, all of whom received stent thrombectomy. The patients were divided into control group (n=40) and treatment group (n=40). Patients in the control group were po administered with Ticagrelor Tablets, 90 mg/time, once daily. Patients in the treatment group were iv administered with Ginkgolide Injection on the basis of the control group, 10 mL was added into 250 mL normal saline, once daily. Both groups completed 14 d therapeutic cycles. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, and the scores of Barthel index, MTICI and NIHSS, the levels of UCH-L1, FGF4 and NPASDP4, and the incidence of complications in two groups before and after treatment were compared. Results After treatment, the results of curative effect analysis showed that the total effective rate of the treatment group was 85.00%, which was significantly higher than that of the conventional control group (65.00%, P < 0.05). In terms of neurological function recovery indexes, BI and MTICI grades were significantly increased in both groups, while NIHSS scores were significantly decreased, and the improvement of indexes in the treatment group was more prominent than that in the control group (P < 0.05). In terms of biomarkers associated with nerve damage, after treatment, the serum levels of UCH-L1, FGF4 and NPASDP4 in two groups were significantly lower than those before treatment (P < 0.05), and the levels of each indicator in the treatment group were significantly lower than those in the control group (P < 0.05). The incidence of complications in the control group and treatment group during the treatment period and within 1 month after the end of the treatment course were 20.00% and 5.00% respectively, and the difference between two groups was statistically significant (P < 0.05). Conclusion Ginkgolide Injection combined with ticagrelor has a significant effect on acute basilar artery occlusive stroke demonstrates significant vascular recanalization, which can not only markedly improve the degree of neurological impairment and self-care ability of patients but also effectively promote the recovery of serum-related indicators and reduce the incidence of complications.

R971

沧州市科技计划自筹经费项目（222106037）