摘要
目的 探讨银杏内酯注射液联合阿加曲班治疗急性脑梗死的临床效果。方法 选取2020年1月—2021年10月江阴市中医院收治的82例急性脑梗死患者,以随机数字表法将患者平均分为对照组(41例)和治疗组(41例)。对照组静脉滴注阿加曲班注射液,第1~2天剂量为60 mg/d,溶入500 mL生理盐水,输注24 h;第3~7天剂量为20 mg/次,溶入250m L生理盐水,1次/d,3 h/次。在对照组基础上,治疗组患者静脉滴注银杏内酯注射液,10 mL/次,溶入250 mL生理盐水,1次/d,滴注速度控制在40~60滴/min。两组均连续治疗14d。观察两组患者临床疗效,比较治疗前后两组患者NIHSS评分,高凝指标血浆纤维蛋白原(FIB)、D-二聚体(D-D)、血小板最大聚集率(MAR)、血栓弹力图参数凝血反应时间(R值)、凝固时间(K值)、α角、最大振幅(MA值)、凝血综合指数(CI值),血清神经元特异性烯醇化酶(NSE)和S100β蛋白、内皮素-1(ET-1)、可溶性细胞间黏附分子1(sICAM-1)和高迁移率族蛋白B1(HMGB1)水平。结果 治疗后,治疗组临床总有效率(92.68%)较对照组(75.61%)显著提高(P<0.05)。与治疗前对比,治疗后两组NIHSS评分和血浆FIB、D-D水平及MAR均显著降低(P<0.05),但均以治疗组的下降更显著(P<0.05)。相较治疗前,治疗后两组血栓弹力图参数R值、K值均显著增加,而α角、MA值和CI值则均显著减小(P<0.05),但均以治疗组的改善更显著(P<0.05)。治疗后,两组血清NSE、S100β蛋白、ET-1、sICAM-1及HMGB1水平均较治疗前显著下降(P<0.05),且治疗后治疗组显著低于对照组(P<0.05)。结论 银杏内酯注射液联合阿加曲班治疗急性脑梗死能明显减轻患者神经功能损伤,纠正血液高凝状态和血管内皮功能紊乱,降低机体炎症反应,促进神经功能恢复,且安全性较好。
Objective To investigate the clinical effect of Ginkgolide Injection combined with argatroban in treatment of acute cerebral infarction. Methods Patients(82 cases) with acute cerebral infarction in Jiangyin Hospital of Traditional Chinese Medicine from January 2020 to October 2021 were randomly divided into control(41 cases) and treatment(41 cases) group. Patients in the control group were iv administered with Argatroban Injection, the dose was 60 mg/d on the 1 — 2 d, drug was dissolved in 500 mL saline for 24 h, and 20 mg/on the 3 — 7 d, drug was dissolved in 250 mL saline once daily, 3 h/time. Patients in the treatment group were iv administered with Ginkgolide Injection on the basis of the control group, 10 mL/time dissolved in 250 mL saline, once daily, the drip speed was controlled at 40 — 60 drops/min. Patients in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, the NIHSS scores, FIB, the levels of plasma D-D, MAR, and TEG, the levels of serum NSE, S100β, ET-1, sICAM-1 and HMGB1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group(92.68%) was significantly higher than that of the control group(75.61)(P < 0.05). The NIHSS score and the levels of plasma FIB, D-D and MAR in two groups were significantly decreased after treatment( P < 0.05), but the decrease in the treatment group was more significant(P < 0.05). Compared with those before treatment, the thromboelastogram parameters R and K in two groups were significantly increased, while the α angle, MA value and CI value significantly decreased(P < 0.05),but the improvement in the treatment group was more significant(P < 0.05). After treatment, the levels of serum NSE, S100 β protein, ET-1,s ICAM-1 and HMGB1 in two groups were significantly lower than those before treatment, and which in the treatment group were significantly lower than those in the control group after treatment(P < 0.05). Conclusion Ginkgolide Injection combined with agatroban in the treatment of acute cerebral infarction can significantly reduce neurological damage, correct blood hypercoagulable state and vascular endothelial dysfunction, reduce inflammatory reaction and promote the recovery of neurological function with good safety.
作者
史一丰
袁鹏
卞鹏飞
张琬蓉
俞悦
SHI Yi-feng;YUAN Peng;BIAN Peng-fei;ZHANG Wan-rong;YU Yue(Department of Neurology,Jiangyin Hospital of Traditional Chinese Medicine,Jiangyin 214431,China)
出处
《现代药物与临床》
CAS
2022年第11期2495-2500,共6页
Drugs & Clinic
基金
江阴市卫生健康委面上科研项目(S202006)。
