目的 探討銀杏內(nèi)酯注射液聯(lián)合吡拉西坦治療急性腦梗死患者的臨床療效。方法 選取2020年1月—2020年12月于焦作市第二人民醫(yī)院診治的136例急性腦梗死患者，隨機(jī)分為對(duì)照組和治療組，每組各68例。對(duì)照組靜脈滴注注射用吡拉西坦，4 g加入生理鹽水250 mL，1次/d；治療組在對(duì)照組基礎(chǔ)上靜脈滴注銀杏內(nèi)酯注射液，5支加入生理鹽水250 mL，1次/d。兩組患者均連續(xù)治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）、功能獨(dú)立性評(píng)價(jià)量表（FIM）和簡(jiǎn)式Fugl-Meyer（FMA）評(píng)分，炎癥反應(yīng)指標(biāo)單核細(xì)胞趨化蛋白-1（MCP-1）、基質(zhì)金屬蛋白酶9（MMP-9）和高遷移率組蛋白1（HMGB1），神經(jīng)細(xì)胞凋亡指標(biāo)缺氧誘導(dǎo)因子-1α（HIF-1α）和S100鈣結(jié)合蛋白β（S100β）水平，促血管新生和神經(jīng)發(fā)生指標(biāo)血管內(nèi)皮生長(zhǎng)因子（VEGF）和腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）水平。結(jié)果 治療后，對(duì)照組臨床有效率為86.76%，明顯低于治療組的97.06%（P<0.05）；治療后，兩組NIHSS評(píng)分較治療前均顯著下降，而FMA、FIM評(píng)分顯著提高（P<0.05），且治療組患者各評(píng)分改善更顯著（P<0.05）。治療后，兩組MCP-1、MMP-9、HMGB1水平均顯著下降（P<0.05），且治療組患者下降更明顯（P<0.05）。治療后，兩組HIF-1α、S100β水平均顯著下降（P<0.05），且治療組下降更明顯（P<0.05）。治療后，兩組VEGF、BDNF水平顯著提高（P<0.05），且治療組升高更明顯（P<0.05）。結(jié)論 銀杏內(nèi)酯注射液聯(lián)合吡拉西坦治療急性腦梗死患者臨床療效較佳，可有效改善患者神經(jīng)功能缺損程度，提高日常生活能力和運(yùn)動(dòng)能力，抑制炎癥反應(yīng)，減輕腦損傷，安全性高。

Objective To investigate the clinical efficacy of Ginkgolide Injection combined with piracetam in treatment of acute cerebral infarction. Methods Patients (136 cases) with acute cerebral infarction in the Second People's Hospital of Jiaozuo from January 2020 to December 2020 were randomly divided into control and treatment groups, and each group had 68 cases. Patients in the control group were iv administered with Piracetam for injection, 4 g added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Ginkgolide Injection on the basis of the control group, 5 g added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS, FIM and FMA scores, the inflammatory reaction indexes of MCP-1, MMP-9 and HMGB1, the level of neuronal apoptosis indexes of HIF-1α and S100β, the angiogenesis and neurogenesis indexes of VEGF and BDNF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the control group was 86.76%, which was significantly lower than 97.06% in the treatment group (P < 0.05). After treatment, the NIHSS scores in two groups were significantly lower than those before treatment, while the scores of FMA and FIM were significantly increased (P < 0.05), and these scores in the treatment group were improved more significantly (P < 0.05). After treatment, the levels of MCP-1, MMP-9, and HMGB1 in two groups were significantly decreased (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of HIF-1α and S100β in two groups were significantly decreased (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of VEGF and BDNF in two groups were significantly increased (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Ginkgolide Injection combined with piracetam has good clinical effect on treatment of acute cerebral infarction, can effectively improve the degree of neurological impairment, improve the ability of daily life and exercise, inhibit inflammatory reaction, reduce brain injury, and have high safety.

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