银杏达莫配合依达拉奉治疗急性脑梗死的应激指标和神经功能变化研究
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摘要
目的:分析银杏达莫配合依达拉奉应用于急性脑梗死,对患者神经功能与应激指标的影响。方法:选取2016年4月至2017年4月朝阳市中心医院收治的急性脑梗死患者112例,按照治疗方案的不同分为对照组(n=54)和观察组(n=58)。对照组予以依达拉奉治疗,观察组予以依达拉奉+银杏达莫治疗,于治疗前1 d、治疗14 d后检测2组神经递质指标、应激指标、神经功能NIHSS评分,比较2组治疗14 d内的疗效。结果:1)观察组在治疗后AOPP(75. 12±3. 74)μmol/L、IL-6(71. 62±5. 01) pg/m L、ox-LDL (85. 80±5. 26) U/m L、CRP (9. 18±0. 55) mg/L、MDA (3. 08±0. 56) nmol/m L、IL-10(22. 13±1. 62)μg/L显著低于对照组,GSH-Px(39. 18±6. 28) mg/m L、SOD(162. 54±13. 15) U/m L显著高于对照组(P <0. 05);(2)观察组在治疗后VAP(8. 12±1. 74) ng/L、NPY(170. 52±6. 15)μg/L、NSE(12. 13±1. 62)μg/L、Glu(71. 62±4. 01)μmol/L显著低于对照组,NGF(89. 18±3. 28) pg/m L、GABA(9. 08±0. 86)μmol/L、NTF (5. 80±0. 76) ng/m L、NAA(429. 18±17. 55) mmol/L显著高于对照组(P <0. 05); 3)观察组在治疗后NIHSS评分总分(11. 50±1. 62)分显著低于对照组(18. 00±1. 78)分(P <0. 05); 4)观察组总有效率(96. 55%)显著高于对照组(87. 04%)(P <0. 05)。结论:对于急性脑梗死,可采取银杏达莫辅助依达拉奉治疗,比较单纯应用依达拉奉,能够有效调节患者应激反应、神经递质表达,提高患者神经功能,疗效较好。
Objective: To analyze the effects of ginkgo combined with edaravone on neurological function and stress index for the patients with acute cerebral infarction. Methods: From April 2016 to April 2017,a total of 112 patients with acute cerebral infarction in Chaoyang Central Hospital were selected. According to the different scheme,they were divided into two groups. The control group( n = 54) was treated with edaravone and the observation group( n = 58) was given ginkgo combined with edaravone. The neurotransmitter index,stress index and NIHSS score of nerve function were detected for 1 day before treatment and 14 days after treatment. The effects were compared between two groups. Results: 1) In the observation group after the treatment,AOPP( 75. 12± 3. 74) μmol/L,IL-6( 71. 62 ± 5. 01) pg/mL,ox-LDL( 85. 80 ± 5. 26) U/mL,CRP( 9. 18 ± 0. 55) mg/L,MDA( 3. 08 ±0. 56) nmol/mL,IL-10( 22. 13 ± 1. 62) μg/L were significantly lower than those in the control group. GSH-Px( 39. 18 ± 6. 28)mg/mL,SOD( 162. 54 ± 13. 15) U/mL were significantly higher than that in the control group( P < 0. 05). 2) In the observation group after the treatment,VAP( 8. 12 ± 1. 74) ng/L,NPY( 170. 52 ± 6. 15) μg/L,NSE( 12. 13 ± 1. 62) μg/L,Glu( 71. 62 ±4. 01) μmol/L were significant lower than those in the control group. NGF( 89. 18 ± 3. 28) pg/mL,GABA( 9. 08 ± 0. 86)μmol/L,NTF( 5. 80 ± 0. 76) ng/mL,NAA( 429. 18 ± 17. 55) mmol/L were significant higher than those in the control group( P< 0. 05). 3) In the observation group after the treatment,the total NIHSS score( 11. 50 ± 1. 62) was significantly lower than that in the control group( 18. 00 ± 1. 78)( P < 0. 05). 4) The total effective rate in the observation group was 96. 55%. It was significantly higher than that in the control group( 87. 04%)( P < 0. 05). Conclusion: For the treatment of acute cerebral infarction,ginkgo can effectively regulate the stress response,neurotransmitter expression and improve the neurological function of the patients compared with edaravone alone.
Objective: To analyze the effects of ginkgo combined with edaravone on neurological function and stress index for the patients with acute cerebral infarction. Methods: From April 2016 to April 2017,a total of 112 patients with acute cerebral infarction in Chaoyang Central Hospital were selected. According to the different scheme,they were divided into two groups. The control group( n = 54) was treated with edaravone and the observation group( n = 58) was given ginkgo combined with edaravone. The neurotransmitter index,stress index and NIHSS score of nerve function were detected for 1 day before treatment and 14 days after treatment. The effects were compared between two groups. Results: 1) In the observation group after the treatment,AOPP( 75. 12± 3. 74) μmol/L,IL-6( 71. 62 ± 5. 01) pg/mL,ox-LDL( 85. 80 ± 5. 26) U/mL,CRP( 9. 18 ± 0. 55) mg/L,MDA( 3. 08 ±0. 56) nmol/mL,IL-10( 22. 13 ± 1. 62) μg/L were significantly lower than those in the control group. GSH-Px( 39. 18 ± 6. 28)mg/mL,SOD( 162. 54 ± 13. 15) U/mL were significantly higher than that in the control group( P < 0. 05). 2) In the observation group after the treatment,VAP( 8. 12 ± 1. 74) ng/L,NPY( 170. 52 ± 6. 15) μg/L,NSE( 12. 13 ± 1. 62) μg/L,Glu( 71. 62 ±4. 01) μmol/L were significant lower than those in the control group. NGF( 89. 18 ± 3. 28) pg/mL,GABA( 9. 08 ± 0. 86)μmol/L,NTF( 5. 80 ± 0. 76) ng/mL,NAA( 429. 18 ± 17. 55) mmol/L were significant higher than those in the control group( P< 0. 05). 3) In the observation group after the treatment,the total NIHSS score( 11. 50 ± 1. 62) was significantly lower than that in the control group( 18. 00 ± 1. 78)( P < 0. 05). 4) The total effective rate in the observation group was 96. 55%. It was significantly higher than that in the control group( 87. 04%)( P < 0. 05). Conclusion: For the treatment of acute cerebral infarction,ginkgo can effectively regulate the stress response,neurotransmitter expression and improve the neurological function of the patients compared with edaravone alone.
引文
[1]杨成.银杏达莫联合依达拉奉治疗急性脑梗死的临床疗效观察[J].实用心脑肺血管病杂志,2016,24(4):97-99.
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[8]张惠卿,张晓敏,董喜英.依达拉奉联合银杏达莫治疗急性脑梗死的临床疗效[J].临床合理用药杂志,2017,10(21):49-50.
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[10]高丽梅.高压氧联合依达拉奉和银杏达莫治疗2型糖尿病并急性脑梗死33例[J].中国药业,2015,24(b11):52-52.
[11]董文生.依达拉奉联合溶栓治疗急性脑梗死对氧自由基清除效果的影响[J].中国实用神经疾病杂志,2016,19(9):66-67.
[12]高倩.依达拉奉注射液联合奥扎格雷钠注射剂治疗后循环缺血的效果观察[J].检验医学与临床,2017,14(Z1):245-246.
[13]Ye L,Cai R,Yang M,et al.Reduction of the systemic inflammatory induced by acute cerebral infarction through ultra-early thrombolytic therapy[J].Exp Ther Med,2015,10(4):1493-1498.
[14]严烨,冷狂风,陈文丽.依达拉奉联合银杏达莫对缺血性脑卒中患者血清白细胞介素6和肿瘤坏死因子α水平的影响[J].中国医院用药评价与分析,2016,16(9):1169-1171.
[15]Guo YL,Li SJ,Zhang ZP,et al.Parameters of diffusional kurtosis imaging for the diagnosis of acute cerebral infarction in different brain regions[J].Exp Ther Med,2016,12(2):933-938.
[16]Momose H,Sorimachi T,Aoki R,et al.Cerebral Infarction following Acute Subdural Hematoma in Infants and Young Children:Predictors and Significance of FLAIR Vessel Hyperintensity[J].Neurol Med Chir(Tokyo),2015,55(6):510-518.
[17]江爱民,龚媛.银杏达莫对急性脑梗死患者血液流变学及炎性指标的影响[J].中国实用神经疾病杂志,2015,18(11):66-67.
[18]王锦华,陈强,汪东良.老年急性脑梗死患者依达拉奉联合神经节苷脂治疗的临床效果及对炎性反应因子的影响[J].中华医院感染学杂志,2015,24(10):2179-2181.
[19]顾群.依达拉奉联合神经节苷脂治疗老年急性脑梗死的临床疗效及安全性评价[J].中国临床药理学杂志,2015,16(12):1079-1081.
[20]李平,汪波.依达拉奉联合溶栓治疗急性脑梗死的疗效及对氧自由基清除效果的影响[J].中国现代医学杂志,2015,25(28):49-52.
[2]牛强.依达拉奉联合银杏达莫治疗脑梗死的临床疗效[J].中国实用神经疾病杂志,2016,19(8):11-13.
[3]Chen Y,Zeng J,Xie X,et al.Clinical features of systemic cancer patients with acute cerebral infarction and its underlying pathogenesis[J].Int J Clin Exp Med,2015,8(3):4455-4463.
[4]Wang J,Yu XD,Li GQ.Comparative study on short-term and longterm prognostic determinants in patients with acute cerebral infarction[J].Int J Clin Exp Med,2015,8(6):9855-9861.
[5]Wang SJ,Qu ZS,Zhang QD,et al.The serum levels of MMP-9,MMP-2 and v WF in patients with low doses of urokinase peritoneal dialysis decreased uremia complicated with cerebral infarction[J].Int J Clin Exp Med,2015,8(8):13017-13027.
[6]Jabbarli R,Reinhard M,Roelz R,et al.Early identification of individuals at high risk for cerebral infarction after aneurysmal subarachnoid hemorrhage:the BEHAVIOR score[J].J Cereb Blood Flow Metab,2015,35(10):1587-1592.
[7]夏克志.浅析银杏达莫联合依达拉奉治疗急性脑梗死的临床疗效及安全性[J].中国现代药物应用,2016,10(20):18-19.
[8]张惠卿,张晓敏,董喜英.依达拉奉联合银杏达莫治疗急性脑梗死的临床疗效[J].临床合理用药杂志,2017,10(21):49-50.
[9]冯琨燕,任广军.银杏达莫联合依达拉奉治疗脑梗死的疗效分析[J].中国实用神经疾病杂志,2014,17(11):82-82,97.
[10]高丽梅.高压氧联合依达拉奉和银杏达莫治疗2型糖尿病并急性脑梗死33例[J].中国药业,2015,24(b11):52-52.
[11]董文生.依达拉奉联合溶栓治疗急性脑梗死对氧自由基清除效果的影响[J].中国实用神经疾病杂志,2016,19(9):66-67.
[12]高倩.依达拉奉注射液联合奥扎格雷钠注射剂治疗后循环缺血的效果观察[J].检验医学与临床,2017,14(Z1):245-246.
[13]Ye L,Cai R,Yang M,et al.Reduction of the systemic inflammatory induced by acute cerebral infarction through ultra-early thrombolytic therapy[J].Exp Ther Med,2015,10(4):1493-1498.
[14]严烨,冷狂风,陈文丽.依达拉奉联合银杏达莫对缺血性脑卒中患者血清白细胞介素6和肿瘤坏死因子α水平的影响[J].中国医院用药评价与分析,2016,16(9):1169-1171.
[15]Guo YL,Li SJ,Zhang ZP,et al.Parameters of diffusional kurtosis imaging for the diagnosis of acute cerebral infarction in different brain regions[J].Exp Ther Med,2016,12(2):933-938.
[16]Momose H,Sorimachi T,Aoki R,et al.Cerebral Infarction following Acute Subdural Hematoma in Infants and Young Children:Predictors and Significance of FLAIR Vessel Hyperintensity[J].Neurol Med Chir(Tokyo),2015,55(6):510-518.
[17]江爱民,龚媛.银杏达莫对急性脑梗死患者血液流变学及炎性指标的影响[J].中国实用神经疾病杂志,2015,18(11):66-67.
[18]王锦华,陈强,汪东良.老年急性脑梗死患者依达拉奉联合神经节苷脂治疗的临床效果及对炎性反应因子的影响[J].中华医院感染学杂志,2015,24(10):2179-2181.
[19]顾群.依达拉奉联合神经节苷脂治疗老年急性脑梗死的临床疗效及安全性评价[J].中国临床药理学杂志,2015,16(12):1079-1081.
[20]李平,汪波.依达拉奉联合溶栓治疗急性脑梗死的疗效及对氧自由基清除效果的影响[J].中国现代医学杂志,2015,25(28):49-52.