目的 探討銀杏二萜內(nèi)酯葡胺聯(lián)合替羅非班治療急性腦梗死的臨床療效。方法 選取2022年1月—2023年12月在河南科技大學(xué)第一附屬醫(yī)院治療的急性腦梗死患者94例，隨機(jī)分為對(duì)照組和治療組，每組各47例。對(duì)照組靜脈滴注鹽酸替羅非班注射液，前30 min以0.4μg/(kg·min)速度滴注，隨后改成0.1μg/(kg·min)維持72 h。治療組患者在對(duì)照組基礎(chǔ)上靜脈滴注銀杏二萜內(nèi)酯葡胺注射液，1次/d，每次取5 mL溶于250 mL生理鹽水。兩組患者給予持續(xù)14 d的治療。觀察兩組患者臨床療效，比較治療前后兩組患者Barthel指數(shù)評(píng)分、美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分和腦卒中改良Rankin量表（mR S）評(píng)分，及血清重組人泛素羧基末端水解酶L1(UCH-L1)、可溶性凝集素樣氧化低密度脂蛋白受體1(Slox-1)和同型半胱氨酸（Hcy）水平。結(jié)果 治療后，對(duì)照組和治療組臨床總有效率分別為78.72%和93.61%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者Barthel指數(shù)均明顯提高，而NIHSS與mR S分值均大幅下降（P<0.05），且治療組得分優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者血清UCH-L1、Slox-1及Hcy水平均顯著下降（P<0.05），且治療組數(shù)值下降程度高于對(duì)照組（P<0.05）。結(jié)論 銀杏二萜內(nèi)酯葡胺聯(lián)合替羅非班治療急性腦梗死療效顯著，能夠明顯緩解神經(jīng)功能缺失并提高日常生活自理能力。

Objective Investigate clinical efficacy of ginkgo diterpene lactone meglumine combined with tirofiban in treatment of acute cerebral infarction. Methods Patients（94 cases） with acute cerebral infarction in the First Affiliated Hospital of Henan University of Science and Technology from January 2022 to December 2023 were randomly divided into control and treatment group,and each group had 47 cases. Patients in the control group were iv administered with Tirofiban Hydrochloride Injection, 0.4μg/（kg·min） for the first 30 min, then adjusted to 0.1 μg/（kg·min） for 72 h. Patients in the treatment group were iv administered with Ginkgo Diterpene Lactone Meglumine Injection, 5 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the scores of Barthel, NIHSS, and mRS, and the serum UCHL1, Slox-1 and Hcy levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 78.72% and 93.61%, respectively, and the difference between the two groups was statistically significant（P＜0.05）. After treatment, the Barthel index in two groups was significantly increased, while the NIHSS and mRS scores were significantly decreased（P＜0.05）, and the score of the treatment group was better than that of the control group（P＜0.05）. After treatment, the serum UCH-L1, Slox-1 and Hcy levels in two groups were significantly decreased（P＜0.05）, and the decrease in the treatment group was higher than that in the control group（P＜0.05）. Conclusion Ginkgo diterpene lactone meglumine combined with tirofiban exhibits pronounced efficacy in treatment of acute cerebral infarction, significantly ameliorating the patients’ neurological deficiency and self-care abilities.

R971

洛陽(yáng)市市級(jí)醫(yī)療衛(wèi)生科技計(jì)劃項(xiàng)目(1920024A)