目的 觀察銀杏達(dá)莫注射液聯(lián)合丁苯肽治療老年急性腦梗死的臨床療效及其安全性。方法 選取2013年9月—2014年12月天津市環(huán)湖醫(yī)院收治的老年急性腦梗死患者74例, 隨機(jī)分為對照組與治療組, 每組各37例。在常規(guī)治療基礎(chǔ)上, 對照組靜脈滴注丁苯酞氯化鈉注射液, 100 mL/次, 1次/d。治療組在對照組的基礎(chǔ)上靜脈點(diǎn)滴銀杏達(dá)莫注射液20 mL加入生理鹽水500 mL, 1次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效, 同時比較兩組治療前后神經(jīng)功能缺損評分(NIHSS)、日常生活活動能力(ADL)評分、血清C反應(yīng)蛋白(CRP)、腫瘤壞死因子-α(TNF-α)、白介素-6(IL-6)、超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、組織纖溶酶原激活物(t-PA)、血栓調(diào)節(jié)蛋白(TM)、組織纖溶酶原激活物抑制物(PAI-1)等指標(biāo)的變化。結(jié)果 治療后, 對照組和治療組的總有效率分別為89.19%、94.59%, 兩組總有效率比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后, 兩組患者NO、SOD、t-PA、ADL評分均較同組治療前顯著升高, MDA、TM、PAI-1、NIHSS評分、CRP、TNF-α、IL-6較同組治療前顯著降低, 同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05);且治療后治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組, 兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 銀杏達(dá)莫注射液聯(lián)合丁苯肽治療老年急性腦梗死具有較好的臨床療效, 能顯著改善腦梗死患者的神經(jīng)和行為功能, 減輕炎癥反應(yīng), 調(diào)節(jié)血漿纖溶系統(tǒng)功能, 清除自由基及提高抗氧化酶活性。

Objective To observe the efficacy and safety of Ginkgo Leaf Extract and Dipyridamole Injection combined with butylphthalide in treatment of elderly acute cerebral infarction. Methods Patients (74 cases) with elderly acute cerebral infarction in Tianjin Huanhu Hospital from September 2013 to December 2014 were randomly divided into control and treatment groups, and each group had 37 cases. The patients in the control group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of conventional treatment, 100 mL/time, once daily. The patients in the treatment group were iv administered with Ginkgo Leaf Extract and Dipyridamole Injection on the basis of control group, 20 mL dissolved in physiological saline 500 mL, once daily. Two groups were treated for 14 d. After treatment, the efficacy was evaluated, and the changes of National Institute of Health stroke scale (NIHSS), activities of daily living (ADL), serum C reaction protein (CRP), TNF-α, IL-6, superoxide dismutase (SOD), Malondialdehyde (MDA), NO, t-PA, thrombomodulin (TM), and PAI-1 in two groups were compared. Results The efficacies in the control and treatment groups were 89.19% and 94.59%, respectively, and there were differences between two groups (P < 0.05). After treatment, NO, SOD, t-PA, and ADL scores in two groups were significantly increased, and MDA, TM, PAI-1, NIHSS score, CRP, TNF-α, and IL-6 were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). Conclusion Ginkgo Leaf Extract and Dipyridamole Injection combined with butylphthalide has good clinical efficacy in treatment of elderly acute cerebral infarction, and can notably improve neurological and behavioral functions, while can significantly reduce inflammatory response and regulate plasma fibrinolytic system, which can remove free radicals and improve the activity of antioxidant enzymes.