银杏二萜内酯联合双抗治疗轻型缺血性脑卒中的近远期效果  

Short-term and Long-term Effects of Ginkgo Diterpene Lactone Glucamine Combined with Dual Antiplatelet in the Treatment of Mild Ischemic Stroke

作　　者：黄志鑫 李东航[1] 王喜江 李树浩[1] HUANG Zhixin;LI Donghang;WANG Xijiang;LIShuhao(Puning Overseas Chinese Hospital,Puning 515300,China)

机构地区：[1]广东省揭阳市普宁华侨医院,广东普宁515300

出　　处：《中国医学创新》2020年第6期1-5,共5页Medical Innovation of China

基　　金：广东省揭阳市卫计局科研立项项目(揭市卫[2019]66号)。

摘　　要：目的:探讨银杏二萜内酯葡胺联合双抗治疗轻型缺血性脑卒中的近期及远期效果。方法:选取本院2019年2-9月收治的80例轻型缺血性脑卒中患者。按照随机数x表法分为单抗组及银杏二萜组,每组40例。单抗组接受硫酸氢氯吡格雷片治疗,银杏二萜组接受银杏二萜内酯葡胺联合阿司匹林肠溶片及硫酸氢氯吡格雷片治疗。比较两组早期神经功能情况及近期治疗效果;比较两组随访期间神经功能恢复情况、凝血功能、新发脑卒中率、出血发生率及死亡率。结果:治疗72 h内,两组美国国立卫生研究院卒中量表(NIHSS)评分均呈先升高后降低趋势,以治疗48 h时最高(P<0.05)。银杏二萜组治疗24、48、72 h时NIHSS评分均低于单抗组(P<0.05);治疗14 d后,银杏二萜组痊愈率高于单抗组,而恶化率低于单抗组(P<0.05)。随访90 d,两组改良Rankin量表(mRS)评分均呈先升高后降低趋势,均以随访30 d最高(P<0.05),银杏二萜组随访60、90 d的mRS评分均低于单抗组(P<0.05)。两组随访90 d内活化部分凝血活酶时间(APTT)呈升高趋势,纤维蛋白原(FIB)呈降低趋势(P<0.05)。两组入组时、随访30 d、60 d及90 d的APTT及FIB比较,差异均无统计学意义(P>0.05)。随访期间银杏二萜组新发脑卒中率低于单抗组(P<0.05)。结论:银杏二萜内酯葡胺联合双抗治疗轻型缺血性脑卒中,可有效预防卒中近期加重、降低卒中再发率并改善远期预后。Objective:To investigate the short-term and long-term effects of Ginkgo Diterpene Lactone Glucamine combined with dual antiplatelet in the treatment of mild ischemic stroke.Method:A total of 80 patients with mild ischemic stroke admitted to our hospital from February to September 2019 were selected.According to the random number table method,they were divided into single antiplatelet group and Ginkgo Diterpene group,40 cases in each group.The single antiplatelet group was treated with Clopidogrel Hydrochloride Tablets.The Ginkgo Diterpene group was treated with Ginkgo Diterpene Lactone Glucamine combined with Aspirin Enteric Tablet and Clopidogrel Hydrochloride Tablets.The early neurological function and the short-term therapeutic effect of the two groups were compared.The neurological recovery,coagulation function,new stroke rate,bleeding rate and mortality during the follow-up were compared between the two groups.Result:Within 72 h of treatment,national institute of health stroke scale (NIHSS) scores in both groups increased first and then decreased,and were highest at 48 h of treatment (P<0.05).The NIHSS scores at 24,48 and 72 h of treatment in the Ginkgo Diterpene group were lower than those of the single antiplatelet group (P<0.05).After 14 d of treatment,the recovery rate of Ginkgo Diterpene group was higher than that of the single antiplatelet group,while the deterioration rate was lower than that of the single antiplatelet group (P<0.05).During follow-up for 90 d,the modified Rankin scale (mRS) score of the two groups increased first and then decreased,with the highest at follow-up for 30 d (P<0.05).The mRS scores of the Ginkgo Diterpene group at follow-up for 60 and 90 d were lower than those of the single antiplatelet group (P<0.05).During follow-up for 90 d,the activated partial thromboplastin time (APTT) increased and the fibrinogen (FIB) decreased in the two groups (P<0.05).There were no significant differences in APTT and FIB between the two groups at enrollment and follow-up for 30,60 and 90 d (P>0

关 键 词：银杏二萜内酯葡胺 阿司匹林肠溶片 硫酸氢氯吡格雷片 缺血性脑卒中 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]