目的觀察銀杏內(nèi)酯注射液聯(lián)合阿替普酶治療急性腦梗死的療效及其對(duì)血清抗氧化因子水平的影響。方法選擇2017年5月-2019年4月河南大學(xué)淮河醫(yī)院收治的90例急性腦梗死患者作為研究對(duì)象，按隨機(jī)數(shù)字表將患者分為對(duì)照組和觀察組，每組各45例。對(duì)照組患者應(yīng)用0.9 mg/kg注射用阿替普酶靜脈溶栓治療，先將阿替普酶溶于生理鹽水配成1 mg/mL的溶液，然后在60 s內(nèi)將10%的混合液靜脈推注，再將余下的混合液在60 min內(nèi)靜脈滴注。觀察組患者在對(duì)照組用藥的基礎(chǔ)上靜脈滴注銀杏內(nèi)酯注射液，10 mL加入到250 mL生理鹽水中，1次/d，連續(xù)用藥14 d。觀察兩組患者的臨床療效，同時(shí)比較兩組治療前后的美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分、Rankin量表（mRS評(píng)分）、血清脂蛋白磷脂酶A2（LpPLA2）、神經(jīng)元特異性烯醇化酶（NSE）、神經(jīng)膠質(zhì)纖維酸性蛋白（GFAP）、超氧化物歧化酶（SOD）、丙二醛（MDA）、一氧化氮（NO）、血管內(nèi)皮生長(zhǎng)因子（VEGF）、腫瘤壞死因子-α（TNF-α）、內(nèi)皮素-1（ET-1）水平。結(jié)果治療后，對(duì)照組和觀察組總有效率分別為46.7%和68.9%，兩組比較差異存在統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者NIHSS評(píng)分、mRS評(píng)分均顯著降低（P<0.05）；且觀察組NIHSS評(píng)分、mRS評(píng)分顯著低于對(duì)照組（P<0.05）。治療后，兩組患者Lp-PLA2、NSE、GFAP水平均顯著降低（P<0.05），且觀察組Lp-PLA2、NSE、GFAP水平顯著低于對(duì)照組（P<0.05）。治療后，兩組患者的血清VEGF、ET-1、TNF-α水平均顯著降低（P<0.05）；且觀察組血清VEGF、ET-1、TNF-α水平顯著低于對(duì)照組（P<0.05）。結(jié)論對(duì)急性腦梗死患者采用銀杏內(nèi)酯注射液聯(lián)合阿替普酶治療，不僅可以顯著減輕患者的神經(jīng)功能缺損，提高近期療效，而且具有提高機(jī)體抗氧化抗炎能力的作用，值得臨床上進(jìn)一步研究應(yīng)用。

Objective To observe the effect of Ginkgolide Injection combined with alteplase in treatment of acute cerebral infarction and its effect on serum antioxidant factor level. Methods A total of 90 patients with acute cerebral infarction admitted to Huaihe Hospital of Henan University from May 2017 to April 2019 were selected as the research subjects. According to the random number table, the patients were divided into control group and observation group, with 45 patients in each group. Patients in the control group were received intravenous thrombolysis with 0.9 mg/kg Alteplase for Injection. Alteplase for Injection was dissolved in normal saline to form 1 mg/mL solution, then 10% of the mixed solution was intravenously injected within 60 s, and the remaining mixed solution was intravenously drip within 60 min. Patients in the observation group was intravenously injected with Ginkgolide Injection on the basis of control group, 10 mL was added into 250 mL normal saline, once daily, treated for 14 d. To observe the clinical efficacy of two groups, and NIHSS score, mRS score, the levels of Lp-PLA2, NSE, GFAP, SOD, MDA, NO, VEGF, TNF-α, and ET-1 before and after treatment were compared. Results After treatment, the total effective rate of the control group and the observation group was 46.7% and 68.9%, respectively, and the difference between two groups was statistically significant (P < 0.05). After treatment, NIHSS score and MRS score in two groups were significantly decreased (P < 0.05), the NIHSS score and mRS score in observation group were significantly lower than those in control group (P < 0.05). After treatment, the levels of Lp-PLA2, NSE, and GFAP in two groups were significantly decreased (P < 0.05), and the levels of Lp-PLA2, NSE, and GFAP in observation group were significantly lower than those in control group (P < 0.05). After treatment, the levels of serum VEGF, ET-1 and TNF-α in two groups were significantly decreased (P < 0.05), the serum levels of VEGF, ET-1, and TNF-α in observation group were significantly lower than those in control group (P < 0.05). Conclusion Ginkgolide Injection combined with alteplase in treatment of patients with acute cerebral infarction can not only significantly reduce the neurological function deficit of patients, improve the short-term efficacy, but also improve the body's antioxidant and anti-inflammatory ability, which is worthy of further clinical research and application.

R971