目的 探討丁苯酞聯(lián)合銀杏葉提取物注射液治療大面積腦梗死的臨床療效。方法 選取2012年6月—2015年6月于威海市中心醫(yī)院神經(jīng)內(nèi)科住院的大面積腦梗死患者130例為研究對象，所有患者按就診時間先后順序隨機(jī)分為對照組和治療組，每組各65例。對照組靜脈滴注銀杏葉提取物注射液，70 mg加入到生理鹽水250 mL，1次/d，連續(xù)使用21 d。治療組在對照組基礎(chǔ)上靜脈滴注丁苯酞氯化鈉注射液，100 mL/次，2次/d，連續(xù)使用14 d，然后改為口服丁苯酞軟膠囊，0.2 g/次，3次/d，連續(xù)使用7 d。觀察兩組的臨床療效，比較兩組的美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、日常生活能力量表（ADL）評分和血漿脂蛋白相關(guān)性磷脂酶A2（LP-PLA2）水平。結(jié)果 治療后，對照組和治療組的總有效率分別為73.85%、93.85%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組NIHSS評分均顯著降低，ADL評分均顯著升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療10、21 d后，兩組血漿LP-PLA2水平均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組LP-PLA2水平明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 丁苯酞聯(lián)合銀杏葉提取物注射液治療大面積腦梗死具有較好的療效，可改善神經(jīng)功能缺損和日常生活活動能力，調(diào)節(jié)血漿LP-PLA2水平，安全性較好，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the effect of butyphthalide combined with Extract of Ginkgo Biloba Leaves Injection in treatment of large area cerebral infarction. Methods Patients (130 cases) with large area cerebral infarction in Weihai Central Hospital from June 2012 to June 2015 were randomly divided into control and treatment groups, and each group had 65 cases. Patients in the control group were iv administered with Extract of Ginkgo Biloba Leaves Injection, 70 mg added into normal saline 250 mL, once daily, treated for 21 d. Patients in the treatment group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of the control group, 100 mL/time, twice daily. After treatment for 14 d, Butylphthalide Soft Capsules before and after treatment were then used for 7 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, ADL scores, and plasma LP-PLA2 level were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.85% and 93.85%, respectively, and there was difference between two groups (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but the ADL scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment for 10 and 21 d, the plasma LP-PLA2 levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Butyphthalide combined with Extract of Ginkgo Biloba Leaves Injection has clinical curative effect in treatment of large area cerebral infarction, can improve neurological deficits and activities of daily living, and regulate the plasma LP-PLA2 level, with good safety, which has a certain clinical application value.