银杏二萜内酯葡胺注射液联合阿替普酶静脉溶栓治疗高龄急性缺血性脑卒中患者的临床疗效

doi:10.3969/j.issn.1671-7171.2021.06.005

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摘要【目的】探讨银杏二萜内酯葡胺注射液(DGMI)联合阿替普酶(rt-PA)静脉溶栓治疗高龄急性缺血性脑卒中(AIS)患者的临床疗效。【方法】选择2018年1月至2020年8月在上海市杨浦区中心医院诊治的86例高龄AIS患者作为研究对象,按照随机数表法观察组和对照组,每组43例。对照组采用rt-PA静脉溶栓治疗,观察组在对照组基础上加用DGMI治疗,治疗2周。比较两组患者治疗后临床疗效及治疗前后神经功能、日常生活活动能力、血清淀粉样蛋白A(SAA)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平及血液流变学参数值。【结果】观察组治疗总有效率为93.02%(40/43),显著高于对照组的74.42%(32/43),其差异有统计学意义(χ²=5.460,P=0.019)。治疗后,两组临床神经功能缺损程度评分(NDS)、血清SAA、Lp-PLA2水平、高切与低切全血黏度及血浆黏度均显著低于同组治疗前(均P<0.05),且观察组显著低于对照组(均P<0.05);治疗后,两组日常生活活动能力量表(ADL)显著高于同组治疗前(均P<0.05),且观察组显著高于对照组(P<0.05)。【结论】采用DGMI联合rt-PA静脉溶栓治疗高龄AIS患者,疗效显著,可有效改善患者血液流变学,明显下调血清SAA、Lp-PLA2水平,降低神经功能缺损程度,提高日常生活活动能力,值得临床推广应用。

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	徐辉
	张晓光
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	聂志余

关键词 ：脑缺血, 卒中, 急性病, 老年人,80以上, 组织型纤溶酶原激活物/治疗应用, 二萜类/治疗应用

Abstract：【Objective】To investigate the clinical efficacy of Ginkgo diterpenoid lactone meglumine injection (DGMI) combined with alteplase (rt-PA) intravenous thrombolysis in the treatment of elderly patients with acute ischemic stroke (AIS). 【Methods】 From January 2018 to August 2020, 86 elderly patients with AIS in Shanghai Yangpu District Central Hospital were selected as the research objects, and the observation group and the control group were randomly divided into two groups, 43 cases in each group. The control group was treated with rt-PA intravenous thrombolysis, and the observation group was treated with DGMI on the basis of the control group for 2 weeks. The clinical efficacy, neurological function, activities of daily living, serum levels of amyloid A (SAA), lipoprotein associated phospholipase A2 (Lp-PLA2) and hemorheological parameters were compared between the two groups before and after treatment. 【Results】The total effective rate of the observation group was 93.02% (40/43), significantly higher than 74.42% (32/43) of the control group, the difference was statistically significant(χ²=5.460,P=0.019). After treatment, the clinical neurological deficit score (NDS), serum SAA, Lp-PLA2 levels, high shear and low shear whole blood viscosity and plasma viscosity of the two groups were significantly lower than those of the same group before treatment (mean P<0.05), and the observation group was significantly lower than that of the control group (mean P<0.05); After treatment, ADL of the two groups was significantly higher than that of the same group before treatment (mean P<0.05), and the observation group was significantly higher than that of the control group (P<0.05). 【Conclusion】 DGMI combined with rt-PA intravenous thrombolysis in the treatment of elderly patients with AIS has significant curative effect, can effectively improve the hemorheology of patients, significantly reduce the serum SAA, Lp-PLA2 levels, reduce the degree of neurological deficit, and improve the ability of daily living, it is worthy of clinical application.

Key words： Brain Ischemia Stroke Acute Disease Aged, 80 and over Tissue Plasminogen Activator/TU Diterpenes/TU

收稿日期: 2020-10-25

中图分类号:

R743.31

基金资助:上海市卫生健康委员会课题(编号:20204Y012)

引用本文:

徐辉, 张晓光, 岳蕴华, 聂志余. 银杏二萜内酯葡胺注射液联合阿替普酶静脉溶栓治疗高龄急性缺血性脑卒中患者的临床疗效[J]. 医学临床研究, 2021, 38(6): 820-823.
XU Hui, ZHANG Xiao-guang, YUE Yun-hua, et al. Clinical Efficacy of Ginkgo Diterpenoid Lactone Meglumine Injection Combined with Alteplase Intravenous Thrombolysis in the Treatment of Elderly Patients with Acute Ischemic Stroke. JOURNAL OF CLINICAL RESEARCH, 2021, 38(6): 820-823.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.06.005 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I6/820