银杏叶提取物联合尼麦角林对急性缺血性脑卒中患者的临床研究  

Clinical trial of Ginkgo biloba extract combined with nicergoline in patients with acute ischemic stroke

作　　者：宋秋英[1] 陶陈娟[1] SONG Qiu-ying;TAO Chen-juan(Department of Neurology,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang Province,China)

机构地区：[1]杭州师范大学附属医院神经内科,浙江杭州310015

出　　处：《中国临床药理学杂志》2021年第5期499-502,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察银杏叶提取物联合尼麦角林对急性缺血性脑卒中(AIS)患者Kelch样环氧氯丙烷相关蛋白-1(Keap1)-核因子-E2相关因子(Nrf2)/抗氧化反应元件(ARE)信号传导通路的影响。方法将136例AIS患者按随机数字表法分为试验组68例与对照组68例。对照组给予尼麦角林片20 mg,每天2次,口服;试验组在对照组基础上给予银杏叶提取物注射液15 mL+0.9%NaCl 250 mL,静脉滴注,每天1次。2组治疗时间均为14 d。于治疗前后用改良Rankin量表(mRS)及美国国立卫生研究院卒中量表(NIHSS)评估2组的生活能力及神经功能;用颈动脉彩超检查评价患者颈动脉-中膜厚度(IMT)、颈动脉斑块面积;用Western blot法检测患者外周中醌氧化还原酶1(NQO1)、Keap1、Nrf2、ARE蛋白水平,观察治疗期间的药物不良反应及预后情况。结果治疗后,试验组及对照组NQO1蛋白水平分别为1.23±0.26,0.89±0.16,Keap1蛋白水平分别为1.08±0.19,1.58±0.24,Nrf2蛋白水平分别为1.10±0.24,0.84±0.20,ARE蛋白水平分别为1.13±0.24,0.80±0.14,IMT水平分别为(0.64±0.09),(0.80±0.13)mm,斑块面积分别为(0.40±0.10),(0.63±0.16)mm2,NIHSS评分分别为(3.75±1.53),(4.30±1.38)分,mRS评分分别为(1.29±0.40),(1.89±0.60)分,差异均有统计学意义(均P<0.05)。试验组和对照组的复发率分别为1.47%(1例/68例),13.24%(9例/68例),预后不良发生率分别为1.47%(1例/68例),11.76%(8例/68例),差异有统计学意义(P<0.05)。试验组出现轻微皮疹3例(4.41%),胃肠道不适1例(1.47%),血压降低1例(1.47%);对照组出现潮热1例(1.47%),恶心1例(1.47%),轻微皮疹2例(2.94%),差异无统计学意义(P>0.05)。结论银杏叶提取物联合尼麦角林治疗AIS疗效确切,利于患者神经功能及预后质量的优化,这可能与银杏叶提取物辅助治疗可改善Keap1-Nrf2/ARE信号传导通路蛋白的异常表达有关。Objective To investigate the effect of Ginkgo biloba extract combined with nigergoline on Kelch-like epichlorohydrin-related protein-1(Keap1)-nuclear factor-E2-related factor(Nrf2)/antioxidative response element(ARE)signaling in patients with acute ischemic stroke Impact of the pathway.Methods A total of 136 patients with AIS were divided into treatment group and control group according to the random number table method,68 cases in each group.Control group was treated with nicergoline tablets 20 mg,twice a day,orally.Treatment group was treated with Ginkgo biloba extract injection 15 mL+0.9%Na Cl 250 m L intravenous drip,once a day,on the basis of control group.The treatment time of both groups was 14 d.The modified Rankin Scale(mRS)and the National Institute of Health stroke scale(NIHSS)were used to evaluate the independent living ability and nerve function in two groups;carotid color doppler ultrasound was used to evaluate the carotid-media thickness(IMT)and carotid plaque area of patients;Western blot was used to detect peripheral quinone oxidoreductase 1(NQO1),Keap1,Nrf2,ARE protein level.The adverse drug reactions occurred during the treatment and the follow-up in two groups were observed.Results After treatment,the levels of NQO1 protein were 1.23±0.26,0.89±0.16,Keap1 protein levels were 1.08±0.19,1.58±0.24,Nrf2 protein levels were 1.10±0.24,0.84±0.20,ARE protein levels were 1.13±0.24,0.80±0.14,the IMT were(0.64±0.09),(0.80±0.13)mm,the plaque area were(0.40±0.10),(0.63±0.16)mm2,the NIHSS scores were 3.75±1.53,4.30±1.38,mRS were 1.29±0.40 and 1.89±0.60,all with significant differences(all P<0.05).The recurrence rates in treatment group and control group were 1.47%(1 case/68 cases),13.24%(9 cases/68 cases),and the incidence of poor prognosis were 1.47%(1 case/68 cases)and 11.76%(8 cases/68 cases),with statistically significant difference(P<0.05).There were 3 cases of mild rash(4.41%),1 case of gastrointestinal discomfort(1.47%),1 case of hypotension(1.47%)in treatment group,and there were 1 ca

关 键 词：银杏叶提取物 尼麦角林 急性缺血性脑卒中 

分 类 号：R28[医药卫生—中药学]