2020 年第 9 期 第 15 卷

脑苷肌肽注射液联合银杏达莫注射液治疗急性脑梗死的效果及对患者炎症反应和高凝状态的影响

Effect of cattle encephalon glycoside and ignotin injection combined with ginkgo leaf extract and dipyridamole injection on acute cerebral infarction and its effect on inflammatory reaction and hypercoagulable state

作者：闫振文1郑眉光2李梅1

英文作者：Yan Zhenwen1 Zheng Meiguang2 Li Mei1 

单位：1中山大学孙逸仙纪念医院神经内科，广州510120；2中山大学孙逸仙纪念医院神经外科，广州510120

英文单位：1Department of Neurology Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou 510120 China; 2Department of Neurosurgery Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou 510120 China

关键词：急性脑梗死；脑苷肌肽；银杏达莫；炎症反应；高凝状态

英文关键词：Acutecerebralinfarction；Cattleencephalonglycosideandignotin；Ginkgoleafextractanddipyridamole；Inflammatoryresponse；Hypercoagulablestate

• 摘要：

• 目的 探讨脑苷肌肽注射液联合银杏达莫注射液治疗急性脑梗死的临床效果及对患者炎症反应和高凝状态的影响。方法 选择2017年1月至2018年12月中山大学孙逸仙纪念医院收治的108例急性脑梗死患者作为研究对象，按随机数字表法将患者分为对照组和观察组，各54例。对照组使用银杏达莫注射液进行治疗；观察组在对照组用药基础上使用脑苷肌肽注射液进行治疗。2组均连续治疗2周。比较2组临床疗效，治疗前后血清炎性因子［白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、高敏C反应蛋白（hs-CRP）］水平、凝血功能指标［血浆纤维蛋白原（FIB）、凝血酶原时间（PT）、平均血小板体积（MPV）］和不良反应情况。结果 观察组总有效率明显高于对照组［92.6%（50/54）比72.2%（39/54）］（P=0.005）。与治疗前相比，治疗后2组IL-6、TNF-α及hs-CRP水平均明显降低，且观察组上述指标水平均明显低于对照组［（9.1±2.2）ng/L比（11.9±3.1）ng/L、（19±5）ng/L比（31±8）ng/L、（6.4±1.7）mg/L比（9.6±2.5）mg/L］（均P＜0.05）。与治疗前相比，治疗后2组FIB及MPV水平均明显降低，PT明显延长，且观察组FIB及MPV均低于对照组［（2.3±0.6）g/L比（2.8±0.7）g/L、（7.4±1.9）fl比（8.5±2.2）fl］，PT长于对照组［（10.8±2.6）s比（10.6±2.5）s］（均P＜0.05）。2组患者不良反应发生率比较，差异无统计学意义(P=0.728)。结论 脑苷肌肽注射液联合银杏达莫注射液治疗急性脑梗死，可明显缓解患者临床症状和神经功能缺损状况，降低炎症应激反应水平，改善凝血功能指标，临床效果较好，且安全性较高。

• Objective To investigate the clinical effect of cattle encephalon glycoside and ignotin injection combined with ginkgo leaf extract and dipyridamole injection in the treatment of acute cerebral infarction and its effect on inflammatory reaction and hypercoagulable state.Methods Totally 108 patients with acute cerebral infarction admitted to Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University from January 2017 to December 2018 were selected. The patients were randomly divided into control group and observation group, with 54 cases in each group. The control group was treated with ginkgo leaf extract and dipyridamole injection, and the observation group was treated with cattle encephalon glycoside and ignotin injection on the basis of the control group. Both groups were treated continuously for two weeks. The clinical effect, serum inflammatory factors ［interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP)］, coagulation indexes ［plasma fibrinogen (FIB), prothrombin time (PT), mean platelet volume (MPV)］ and adverse reactions were compared between the two groups. Results The total effective rate of observation group was significantly higher than that of control group［92.6%（50/54） vs 72.2%（39/54）］（P=0.005）. After treatment, the indexes of IL-6, TNF-α and hs-CRP in the two groups were significantly lower than before treatment, and the above indexes in the observation group were significantly lower than those in the control group ［（9.1±2.2）ng/L vs （11.9±3.1）ng/L,（19±5）ng/L vs （31±8）ng/L,（6.4±1.7）mg/L vs （9.6±2.5）mg/L］(all P＜0.05). After treatment, the FIB and MPV indexes in the two groups were significantly lower and the PT indexes were significantly higher than before treatment, and the FIB and MPV indexes in the observation group were lower than those in the control group［（2.3±0.6）g/L vs （2.8±0.7）g/L,（7.4±1.9）fl vs （8.5±2.2）fl］, and the PT index in the observation group was higher than that in the control group［（10.8±2.6）s vs （10.6±2.5）s］(all P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P=0.728). Conclusions Cattle encephalon glycoside and ignotin injection combined with ginkgo leaf extract and dipyridamole injection in the treatment of acute cerebral infarction can significantly improve the clinical symptoms and neurological deficits of patients, reduce the level of inflammatory stress response, and improve coagulation function indicators. It has good clinical effect and high safety.