銀杏達莫配合依達拉奉治療急性腦梗死的應激指標和神經功能變化研究

于海娜 劉永丹 裴曉蕊

摘要? 目的：分析銀杏達莫配合依達拉奉應用于急性腦梗死，對患者神經功能與應激指標的影響。方法：選取2016年4月至2017年4月朝陽市中心醫院收治的急性腦梗死患者112例，按照治療方案的不同分為對照組（ n =54）和觀察組（ n =58）。對照組予以依達拉奉治療，觀察組予以依達拉奉+銀杏達莫治療，于治療前1 d、治療14 d后檢測2組神經遞質指標、應激指標、神經功能NIHSS評分，比較2組治療14 d內的療效。結果：1）觀察組在治療后AOPP（75.12±3.74）μmol/L、IL-6（71.62±5.01）pg/mL、ox-LDL（85.80±5.26）U/mL、CRP（9.18±0.55）mg/L、MDA（3.08±0.56）nmol/mL、IL-10（22.13±1.62）μg/L顯著低于對照組，GSH-Px（39.18±6.28）mg/mL、SOD（162.54±13.15）U/mL顯著高于對照組（ P <0.05）;（2）觀察組在治療后VAP（8.12±1.74）ng/L、NPY（170.52±6.15）μg/L、NSE（12.13±1.62）μg/L、Glu（71.62±4.01）μmol/L顯著低于對照組，NGF（89.18±3.28）pg/mL、GABA（9.08±0.86）μmol/L、NTF（5.80±0.76）ng/mL、NAA（429.18±17.55）mmol/L顯著高于對照組（ P <0.05）;3）觀察組在治療后NIHSS評分總分（11.50±1.62）分顯著低于對照組（18.00±1.78）分（ P <0.05）;4）觀察組總有效率（96.55%）顯著高于對照組（87.04%）（ P <0.05）。結論：對于急性腦梗死，可采取銀杏達莫輔助依達拉奉治療，比較單純應用依達拉奉，能夠有效調節患者應激反應、神經遞質表達，提高患者神經功能，療效較好。

關鍵詞? 銀杏達莫;依達拉奉;急性腦梗死;應激指標;神經功能;神經遞質;應激反應;NIHSS評分

Study on the Effects of Ginkgo Combined with Edaravone on Stress Indexes and Changes of Neurological Function in Treatment of Acute Cerebral Infarction

Yu Haina1， Liu Yongdan2， Pei Xiaorui1

（1 Chaoyang Central Hospital， Chaoyang 122000， China; 2 Department of Neurology， Hospital of Heilongjiang Province， Harbin 150036， China）

Abstract Objective： To analyze the effects of ginkgo combined with edaravone on neurological function and stress index for the patients with acute cerebral infarction.? Methods： From April 2016 to April 2017， a total of 112 patients with acute cerebral infarction in Chaoyang Central Hospital were selected. According to the different scheme， they were divided into two groups. The control group （ n =54） was treated with edaravone and the observation group （ n =58） was given ginkgo combined with edaravone. The neurotransmitter index， stress index and NIHSS score of nerve function were detected for 1 day before treatment and 14 days after treatment. The effects were compared between two groups.? Results： 1） In the observation group after the treatment， AOPP （75.12±3.74） μmol/L， IL-6 （71.62±5.01） pg/mL， ox-LDL （85.80±5.26） U/mL， CRP （9.18±0.55） mg/L， MDA （3.08±0.56） nmol/mL， IL-10 （22.13±1.62） μg/L were significantly lower than those in the control group. GSH-Px （39.18±6.28） mg/mL， SOD （162.54±13.15） U/mL were significantly higher than that in the control group （ P <0.05）. 2） In the observation group after the treatment， VAP （8.12±1.74） ng/L， NPY （170.52±6.15） μg/L， NSE （12.13±1.62） μg/L， Glu （71.62±4.01） μmol/L were significant lower than those in the control group. NGF （89.18±3.28） pg/mL， GABA （9.08±0.86） μmol/L， NTF （5.80±0.76） ng/mL， NAA （429.18±17.55） mmol/L were significant higher than those in the control group （ P <0.05）. 3） In the observation group after the treatment， the total NIHSS score （11.50±1.62） was significantly lower than that in the control group （18.00±1.78） （ P <0.05）. 4） The total effective rate in the observation group was 96.55%. It was significantly higher than that in the control group （87.04%） （ P <0.05）.? Conclusion： For the treatment of acute cerebral infarction， ginkgo can effectively regulate the stress response， neurotransmitter expression and improve the neurological function of the patients compared with edaravone alone.

Key Words? Ginkgo; Edaravone; Acute cerebral infarction; Stress index; Neurofunction; Neurotransmitter; Stress response; NIHSS score

中圖分類號：R255.2 文獻標識碼：A? doi： 10.3969/j.issn.1673-7202.2019.02.030

目前，臨床治療急性腦梗死以藥物干預為主。依達拉奉是自由基清除劑，具有改善腦梗死局部腦血流量，阻止病情進展，緩解神經癥狀的作用[1]。銀杏達莫是銀杏葉提取物的中藥復方制劑，在促進血液循環、擴張腦血管方面有一定作用[2]。本研究通過分析對急性腦梗死患者應用銀杏達莫輔助依達拉奉在改善神經功能和應激指標方面的作用，旨在為本病治療提供新的科學依據，根據研究結果報道如下。……