银杏叶提取物片联合双联抗血小板治疗急性脑梗死患者的疗效及对脑血流和血清ANXA2、Hcy、ET-1水平的影响  

Efficacy of Ginkgo biloba extract tablets combined with dual antiplatelet therapy in the treatment of acute cerebral infarction patients and its effects on cerebral blood flow and serum levels of ANXA2,Hcy and ET-1

作　　者：赵静[1] 边林 李艳军 邢亮 张海飞[1] 周玉瑾 ZHAO Jing;BIAN Lin;LI Yan-jun(Department of Neurology,The Fifth People's Hospital of Datong,Datong Shanxi 037000,China)

机构地区：[1]大同市第五人民医院神经内科,山西大同03700

出　　处：《临床和实验医学杂志》2025年第1期1-5,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省卫健委课题(编号:2022091)。

摘　　要：目的观察银杏叶提取物片联合双联抗血小板治疗急性脑梗死患者的疗效及对脑血流和血清膜联蛋白A2(ANXA2)、同型半胱氨酸(Hcy)、内皮素-1(ET-1)水平的影响。方法前瞻性选取2021年10月至2023年10月大同市第五人民医院神经内科的158例急性脑梗死患者作为研究对象。按照简单随机法将患者分为两组:双抗组79例、银杏叶组79例。两组均给予静脉溶栓、降颅压﹑减轻水肿﹑神经保护等常规治疗,双抗组给予双联抗血小板治疗,银杏叶组在双抗组基础上给予银杏叶提取物片治疗。统计两组疗效,评估两组患者治疗前、治疗2周后的美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)差异,检测并比较两组治疗前、治疗2周后的神经相关因子[脑源性神经营养因子(BDNF)、泛素羧基末端水解酶L1(UCH-L1)、神经元特异性烯醇化酶(NSE)、S-100β]、ANXA2、Hcy、ET-1水平以及大脑中动脉血流[搏动指数(PI)、阻力指数(RI)、平均血流速度(Vm)、收缩期峰值流速(Vs)]变化。结果银杏叶组总有效率为91.14%,高于双抗组(79.75%),差异有统计学意义(P<0.05)。治疗2周后,两组NIHSS评分均较治疗前降低,BI评分均较治疗前升高,且银杏叶组的NIHSS评分较双抗组更低,BI评分较双抗组更高,差异均有统计学意义(P<0.05)。治疗2周后,两组UCH-L1、NSE、S-100β水平均较治疗前降低,BDNF均较治疗前升高,且银杏叶组的UCH-L1、NSE、S-100β均较双抗组更低,BDNF较双抗组更高,差异均有统计学意义(P<0.05)。治疗2周后,两组ANXA2水平均较治疗前升高,Hcy、ET-1水平均较治疗前降低,且银杏叶组的ANXA2水平较双抗组更高,Hcy、ET-1水平较双抗组更低,差异均有统计学意义(P<0.05)。治疗2周后,两组PI、RI均较治疗前降低,Vm、Vs均较治疗前升高,且银杏叶组的PI、RI均较双抗组更低,Vm、Vs均较双抗组更高,差异均有统计学意义(P<0.05)。结论银杏叶提取物片�Objective To observe the efficacy of Ginkgo biloba extract tablets combined with dual antiplatelet therapy in the treatment of acute cerebral infarction patients and its effects on cerebral blood flow and serum levels of membrane associated protein A2(ANXA2),homocysteine(Hcy)and endothelin-1(ET-1).Methods A total of 158 patients with acute cerebral infarction in the Department of Neurology,the Fifth People's Hospital of Datong from October 2021 to October 2023 were prospectively selected as the study subjects.The patients were divided into two groups according to the simple random method:79 cases in the dual antiplatelet group and 79 cases in the Ginkgo biloba group.Both groups received conventional treatments including intravenous thrombolysis,decompression,dehydration therapy and neuroprotection.The dual antiplatelet group received dual antiplatelet therapy,while the Ginkgo biloba group received additional Ginkgo biloba extract tablets treatment on top of the dual antiplatelet therapy.The efficacy of the two groups was statistically analyzed.The differences of National Institutes of Health stroke scale(NIHSS)score and Barthel index(BI)between the two groups before and after 2 weeks of treatment were evaluated.The changes of nerve-related factors[brain-derived neurotrophic factor(BDNF),ubiquitin carboxyl-terminal hydrolase L1(UCH-L1),neuron-specific enolase(NSE),S-100β],ANXA2,Hcy,ET-1 levels and middle cerebral artery blood flow[pulsatility index(PI),resistance index(RI),mean blood flow velocity(Vm),peak systolic velocity(Vs)]were detected and compared between the two groups before and after 2 weeks of treatment.Results The total effective rate of the Ginkgo biloba group was 91.14%,which was higher than that of the dual antibody group(79.75%),and the difference was statistically significant(P<0.05).After 2 weeks of treatment,the NIHSS scores of the two groups were lower than those before treatment,and the BI scores were higher than those before treatment,and the NIHSS score of the Ginkgo biloba group was lower

关 键 词：银杏叶提取物 双联抗血小板 急性脑梗死 脑血流 疗效 

分 类 号：R743.33[医药卫生—神经病学与精神病学]