目的 探討銀杏達(dá)莫注射液聯(lián)合注射用阿替普酶治療急性腦梗死患者的臨床療效。方法 選擇2018年6月—2020年6月上海市浦東新區(qū)周浦醫(yī)院收治的90例急性腦梗死患者作為研究對(duì)象，將全部患者隨機(jī)分為治療組和對(duì)照組，每組各45例。對(duì)照組靜脈滴注注射用阿替普酶，0.9 mg/kg溶于100 mL生理鹽水中，最大給藥劑量不超過(guò)90 mg；1 min內(nèi)注射總劑量的10%，剩余90%在1 h內(nèi)注射完成。治療組在對(duì)照組治療的基礎(chǔ)上靜脈滴注銀杏達(dá)莫注射液，10 mL加入生理鹽水250 mL中，1次/d，連續(xù)治療7 d。觀察兩組患者的臨床療效，比較兩組治療前后神經(jīng)功能、腦血流動(dòng)力學(xué)指標(biāo)和氧化應(yīng)激指標(biāo)。結(jié)果 治療后，治療組患者的總有效率（95.6%）顯著高于對(duì)照組的總有效率（82.2%），兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分較治療前顯著降低（P<0.05）；且治療后治療組的NIHSS評(píng)分顯著低于對(duì)照組（P<0.05）。治療后，兩組患者的平均頸動(dòng)脈血流量（Q_均值）、平均血流速度（V_均值）、外周阻力顯著高于治療前，特征阻抗顯著低于治療前（P<0.05）；且治療后治療組Q_均值、V_均值、外周阻力顯著高于對(duì)照組，特征阻抗顯著低于對(duì)照組（P<0.05）。治療后，兩組的氧化蛋白產(chǎn)物（AOPP）、丙二醛（MDA）水平顯著低于治療前，超氧化物歧化酶（SOD）水平顯著高于治療前（P<0.05）；且治療組AOPP、MDA水平顯著低于對(duì)照組，SOD水平顯著高于對(duì)照組（P<0.05）。結(jié)論 銀杏達(dá)莫注射液聯(lián)合注射用阿替普酶治療急性腦梗死患者具有較好的臨床療效，能顯著改善神經(jīng)功能和腦血流動(dòng)力，降低氧化應(yīng)激反應(yīng)。

Objective To study the clinical efficacy of Ginkgo Leaf Extract and Dipyridamole Injection combined with Alteplase for injection in treatment of acute cerebral infarction. Methods Patients (90 cases) with acute cerebral infarction in Shanghai Pudong New District Zhoupu Hospital from June 2018 to June 2020 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were iv administered with Alteplase for injection, 0.6 mg/kg added into normal saline 100 mL, the maximum dosage shall not exceed 60 mg, 10% of the total dose was injected within 1 min, and the remaining 90% was completed within 1 h. Patients in the treatment group were iv administered with Ginkgo Leaf Extract and Dipyridamole Injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily, treated for 7 d. After treatment, the clinical efficacies were evaluated, and neurological function, cerebral hemodynamic indexes, and oxidative stress indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group (95.6%) was significantly higher than that of the control group (82.2%), and the difference was statistically significant between two groups (P<0.05). After treatment, the NIHSS scores of two groups was significantly lower than that before treatment (P<0.05). After treatment, the NIHSS score of the treatment group was significantly lower than that of the control group (P<0.05). After treatment, Q_means, V_means, and peripheral resistance levels of two groups were significantly higher than those before treatment, but characteristic impedance was significantly lower than that before treatment (P<0.05). After treatment, the Q_means, V_means, and peripheral resistance levels in the treatment group were significantly higher than those in the control group, but the characteristic impedance was significantly lower than that in the control group (P<0.05). After treatment, the levels of AOPP and MDA in two groups were significantly lower than those before treatment, but the levels of SOD in two groups were significantly higher than those before treatment (P<0.05). After treatment, the levels of AOPP and MDA in the treatment group were significantly lower than those in the control group, but the levels of SOD in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Ginkgo Leaf Extract and Dipyridamole Injection combined with Alteplase for injection can significantly improve neurological function and cerebral hemodynamics, and reduce oxidative stress in patients with acute cerebral infarction.

R971

上海健康醫(yī)學(xué)院附屬周浦醫(yī)院院級(jí)課題（ZPXM-2019B-05）