银杏达莫联合乌司他丁治疗创伤性脑出血患者的临床研究  

Clincal effect of Ginkgo leaf extract and dipyridamole combined with ulinastatin in the treatment of patients with traumatic cerebral hemorrhage

作　　者：魏志玄[1] 张婷[2] 王博[1] 崔群建[1] WEI Zhi-xuan;ZHANG Ting;WANG Bo;CUI Qun-jian(Department of Neurosurgery,First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China;Department of Basic Medicine,Nanyang Medical College,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳医学高等专科学校第一附属医院神经外科,河南南阳473000 [2]南阳医学高等专科学校基础医学部,河南南阳473000

出　　处：《中国临床药理学杂志》2021年第10期1138-1141,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探究银杏达莫联合乌司他丁治疗创伤性脑出血疗效及对血清表皮生长因子样结构域(EGFL7)表达的影响。方法将116例创伤性脑出血患者,用随机数字法分为对照组和试验组,各58例。对照组将注射用乌司他丁4×10^(5) U溶于生理盐水100 mL,静脉滴注,每天2次,用药时间间隔≥6 h;试验组在对照组的基础上给予银杏达莫注射液5 mL溶于0.9%氯化钠溶液250 mL中,静脉滴注,每天1次。2组均治疗14 d。比较2组患者的EGFL7、血肿体积、美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、炎症反应指标及氧化应激反应指标,同时观察2组治疗期间药物不良反应发生情况。结果治疗后,试验组和对照组EGFL7水平分别为(1.05±0.20),(1.68±0.23)μg·mL^(-1),血肿量分别为(7.15±0.95),(9.94±1.67)mL,白细胞介素-8(IL-8)分别为(30.98±3.30),(41.41±4.17)μg·L^(-1),正五聚蛋白3(PTX-3)分别为(1.78±0.31),(2.74±0.39)ng·L^(-1),血管细胞黏附分子-1 (VCAM-1)分别为(28.99±3.90),(40.24±4.39)ng·L^(-1),核因子-κB(NF-κB)分别为(0.71±0.09),(0.97±0.16)U·L^(-1),丙二醛(MDA)分别为(3.39±0.43),(5.91±0.48)μmol·L^(-1),过氧化物酶体增殖物激活受体γ(PPARγ)分别为(1.65±0.35),(2.18±0.46)μg·L^(-1),活性氧(ROS)分别为(6.62±1.04),(9.11±1.37)U·L^(-1),缺血修饰清蛋白(IMA)分别为(68.45±5.74),(84.55±8.61)U·L^(-1),NIHSS分别为(6.59±1.43),(10.36±1.63)分,GCS评分分别为(14.76±2.59),(10.71±1.41)分,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为15.52%,13.79%,差异无统计学意义(P>0.05)。结论银杏达莫联合乌司他丁能够有效减轻由创伤激发的全身炎症、氧化应激反应,促进脑血管内皮细胞增殖、迁移、黏附,且对创伤性脑出血患者血肿清除程度高,可进一步促进患者神经功能的恢复并减轻其昏迷程度。Objective To explore the clincial effect of Ginkgo leaf extract and dipyridamole combined with ulinastatin in the treatment of patients with traumatic cerebral hemorrhage and its effect on the expression of serum epidermal growth factor like domain(EGFL7). Methods A total of 116 patients with traumatic cerebral hemorrhage were randomly divided into control group and treatment group, 58 cases in each group. Control group was given ulinastatin for injection 4×10^(5) U dissolved in normal saline 100 mL, intravenous drip, bid, medication interval ≥6 h. On the basis of control group,treatment group was given Ginkgo leaf extract and dipyridamole injection 5 mL dissolved in 0. 9 % NaCl 250 mL for intravenous drip,qd. Both groups were treated for 14 d.EGFL7,hematoma volume,National Institutes of Health Stroke Scale( NIHSS) score,Glasgow Coma Scale( GCS) score,inflammatory reaction index and oxidative stress reaction index were compared between the two groups,and the incidence of adverse drug reactions during treatment were observed. Results After treatment,the EGFL7 levels of treatment group and control group were( 1. 05 ± 0. 20),( 1. 68 ± 0. 23) μg · mL-1,the volume of hematoma were( 7. 15 ± 0. 95),( 9. 94 ± 1. 67) mL,interleukin-8( IL-8) were( 30. 98 ± 3. 30),( 41. 41 ±4. 17) μg·L^(-1),pentamerin 3( PTX-3) were( 1. 78 ± 0. 31),( 2. 74 ± 0. 39) ng·L^(-1),vascular cell adhesion molecule-1( VCAM-1) were( 28. 99 ± 3. 90),( 40. 24 ± 4. 39) ng·L^(-1),nuclear factor κB( NF-κB)were( 0. 71 ± 0. 09),( 0. 97 ± 0. 16) U · L^(-1),malondialdehyde( MDA) were( 3. 39 ± 0. 43),( 5. 91 ± 0. 48)μmol·L^(-1),peroxisome proliferator activated receptor γ( PPARγ) were( 1. 65 ± 0. 35),( 2. 18 ± 0. 46) μg·L^(-1),reactive oxygen species( ROS) were( 6. 62 ± 1. 04),( 9. 11 ± 1. 37) U · L^(-1),ischemia modified albumin( IMA)were( 68. 45 ± 5. 74),( 84. 55 ± 8. 61) U·L^(-1),NIHSS scores were( 6. 59 ± 1. 43) and( 10. 36 ± 1. 63) points,the GCS scores were( 14. 76 ± 2. 59) and( 10. 71 ± 1. 41) points,all with

关 键 词：银杏达莫 乌司他丁 创伤性脑出血 表皮生长因子样结构域 

分 类 号：R28[医药卫生—中药学]