目的 探討銀杏內(nèi)酯注射液聯(lián)合阿替普酶靜脈溶栓治療急性缺血性腦卒中的安全性及臨床療效。方法 選取87例急性缺血性腦卒中患者，分為對照組及試驗組。對照組39例，給予阿替普酶靜脈溶栓治療，10%注射用阿替普酶（0.9 mg/kg）iv，其余90%在1 h內(nèi)靜脈滴注完畢，后給予生理鹽水iv，24 h后給予缺血性卒中的基礎(chǔ)用藥；試驗組48例，在相同方法靜脈溶栓后立刻給予銀杏內(nèi)酯注射液，6 mL加入250 mL生理鹽水中，靜脈滴注，1次/d，連續(xù)用藥14 d，溶栓24 h后給予缺血性卒中的基礎(chǔ)用藥。所有入選患者分別于治療前、治療后14、90d記錄美國國立衛(wèi)生研究院卒中量表（NIHSS）評分，并記錄不良反應(yīng)事件，治療后14、90 d進(jìn)行改良Rankin量表（mRS）評分1次、檢測BI指數(shù)1次。按照TOAST分型將兩組患者進(jìn)行分類，并對大動脈粥樣硬化型及小動脈閉塞型患者進(jìn)行分析。結(jié)果 兩組患者用藥后均未出現(xiàn)顱內(nèi)出血；用藥后90 d，試驗組的NIHSS評分、mRS評分較對照組顯著降低，BI指數(shù)顯著升高；試驗組的大動脈粥樣硬化型患者用藥后90 d的NIHSS評分、mRS評分較對照組明顯降低，BI指數(shù)顯著升高；而小動脈粥樣硬化型患者與對照組比較差異不顯著。結(jié)論 銀杏內(nèi)酯注射液聯(lián)合阿替普酶靜脈溶栓治療急性缺血性腦卒中患者安全性高，且明顯改善患者預(yù)后。

Objective To explore the safety and clinical efficacy of Ginkgo biloba lactone injection combined with Alteplase intravenous thrombolysis in treatment of acute ischemic stroke. Methods Totally 87 patients were recruited and divided into control group and test group. The, patients in control group(39 cases) were given Alteplase0.9 mg/kg for injection, intravenous bolus total dose 10% was given within 1 min, then intravenous infusion of the remaining 90% was given in 1 h, and given basic therapy after 24 h. The 48 cases in test group, which were immediately iv Ginkgo biloba lactone injection after intravenous thrombolysis, 6 mL added into 250 mL saline, once daily for 14 d, and also were given basic therapy after 24 h. All NIHSS scores were recorded before treatment, 14 d and 90 d after treatment, and the adverse events were recorded. The modified Rankin scale (mRS) score and BI index were performed at 14 and 90 d after admission. Patients in two groups were classified according to the TOAST classification, and the patients with large-arteryatherosclerosis and small-artery occlusion were analyzed. Results No intracranial hemorrhage occurred in the two groups. The NIHSS score and mRS scoreof test group were significantly lower than that of control group, and BI index was significantly increased 90 d after treatment. The NIHSS score and mRS scoreof test group were significantly lower than that of control group, and BI index was significantly increased90 d after treatment of patients with large-artery atherosclerosis. But there was no significant difference between test group and control group of patients with small-artery occlusion. Conclusion Ginkgo biloba lactone injection combined with rt-PA intravenous thrombolysis in the treatment of acute ischemic stroke has high safety, and can improve the prognosis of patients.