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银杏二萜内酯葡胺注射液联合阿替普酶治疗大血管闭塞性急性缺血性脑卒中的临床效果观察

Clinical efficacy of Ginkgo Diterpene Lactone Meglumine Injection combined with alteplase in treatment of acute ischemic stroke with large vessel occlusion

    摘要
  • 摘要:
    目的 观察银杏二萜内酯葡胺注射液联合阿替普酶(rt-PA)治疗大血管闭塞性急性缺血性脑卒中的临床效果。
    方法 选取170例大血管闭塞性急性缺血性脑卒中患者作为研究对象, 随机分为对照组(接受rt-PA静脉溶栓治疗)和观察组(在对照组基础上加用银杏二萜内酯葡胺注射液治疗)，每组85例。比较2组患者血清学指标神经元特异性烯醇化酶(NSE)、血管内皮生长因子(VEGF)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)水平、大脑中动脉血流速度舒张末期血流速度(EDV)、收缩期峰值流速(PSV)、平均血流速度(Vm)、神经功能美国国立卫生研究院卒中量表(NIHSS)评分、认知功能简易精神状态检查量表(MMSE)评分、改良Rankin量表(mRS)评分和并发症发生情况。
    结果 治疗后, 2组血清NSE、Hcy、hs-CRP、MMP-9水平和NIHSS评分、mRS评分均低于治疗前，血清VEGF水平和MMSE评分均高于治疗前，且观察组血清NSE、Hcy、hs-CRP、MMP-9水平和NIHSS评分、mRS评分低于对照组，血清VEGF水平和MMSE评分高于对照组，差异有统计学意义(P < 0.05)。治疗后, 2组EDV、PSV、Vm均高于治疗前，且观察组高于对照组，差异有统计学意义(P < 0.05)。2组并发症总发生率比较，差异无统计学意义(P>0.05)。
    结论 银杏二萜内酯葡胺注射液联合rt-PA治疗大血管闭塞性急性缺血性脑卒中，可有效改善患者的神经功能与认知功能。

     

    Abstract:
    Objective To observe the clinical efficacy of Ginkgo Diterpene Lactone Meglumine Injection combined with alteplase (rt-PA) in the treatment of acute ischemic stroke with large vessel occlusion.
    Methods A total of 170 patients with acute ischemic stroke with large vessel occlusion were selected as the study subjects and randomly divided into control group (receiving intravenous rt-PA thrombolytic therapy) and observation group (receiving Ginkgo Diterpene Lactone Meglumine Injection in addition to the treatment in the control group), with 85 cases in each group. Serological indicatorsneuron-specific enolase (NSE), vascular endothelial growth factor (VEGF), homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), matrix metalloproteinase-9 (MMP-9), cerebral blood flow velocity in the middle cerebral arteryend-diastolic velocity (EDV), peak systolic velocity (PSV), mean velocity (Vm), neurological functionNational Institutes of Health Stroke Scale (NIHSS) score, cognitive functionMini-mental State Examination (MMSE) score, modified Rankin Scale (mRS) score, and the incidence of complications were compared between the two groups.
    Results After treatment, the serum levels of NSE, Hcy, hs-CRP, MMP-9, and the NIHSS and mRS scores in both groups were lower than those before treatment, while the serum level of VEGF and the MMSE score were higher than those before treatment(P < 0.05). Moreover, the serum levels of NSE, Hcy, hs-CRP, MMP-9, and the NIHSS and mRS scores in the observation group were lower than those in the control group, and the serum level of VEGF and the MMSE score were higher than those in the control group, with statistically significant differences (P < 0.05). After treatment, the EDV, PSV and Vm in both groups were higher than those before treatment, and those in the observation group were higher than those in the control group, with statistically significant differences (P < 0.05). There was no statistically significant difference in the overall incidence of complications between the two groups (P>0.05).
    Conclusion Ginkgo Diterpene Lactone Meglumine Injection combined with rt-PA can effectively improve the neurological and cognitive functions of acute ischemic stroke patients with large vessel occlusion.

     

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