王楠楠 周寒松 顾新艳 陈运 陈言晓

摘要 目的：探讨银杏二萜内酯葡胺注射液治疗缺血性脑卒中的效果及对颈动脉斑块的影响。方法：选取2018年1月至2020年11月淮安市第二人民医院收治的缺血性脑卒中患者83例作为研究对象进行回顾性分析。根据用药方法不同分为对照组（n=42）和观察组（n=41）。对照组采取重组组织型纤溶酶原激活剂（rt-PA）溶栓治疗，观察组在对照组基础上给予银杏二萜内酯葡胺注射液。比较2组患者的治疗效果、神经功能、生命质量、炎症介质、颈动脉斑块情况、不良反应情况。结果：观察组的临床治疗效果优于对照组（P<0.05）。在治疗后，观察组的NIHSS评分、C反应蛋白（CRP）、白细胞介素-1β（IL-1β）、同型半胱氨酸（Hcy）、白细胞介素-2（IL-2）、颈动脉内膜-中层厚度、硬化斑块指数均低于对照组，Barthel指数高于对照组（P<0.05）。2组患者的不良反应发生率差异无统计学意义（P>0.05）。结论：在窗口期内顺利接受rt-PA溶栓治疗的缺血性脑卒中患者，给予银杏二萜内酯葡胺注射液进行联合治疗，可进一步提升治疗效果，改善神经功能以及生命质量，稳定血清学指标以及頸动脉斑块情况，治疗的安全性良好。

关键词 银杏二萜内酯葡胺注射液;缺血性脑卒中;颈动脉斑块;静脉溶栓;中医;心脑血管疾病;言语功能;肢体功能

Abstract Objective：To explore the effects of ginkgo diterpene lactone meglumine injection in the treatment of ischemic stroke and its effect on carotid plaque.Methods：A total of 83 patients with ischemic stroke treated in the Second People′s Hospital of Huai′an City from January 2018 to November 2020 were retrospectively analyzed.According to different medication methods，they were divided into a control group（n=42）and an observation group（n=41）.The control group was given thrombolytic therapy with recombinant tissue-type plasminogen activator（rt-PA），and the observation group was given Ginkgo diterpene lactone meglumine injection based on the treatment method of the control group.The treatment effect，nerve function，quality of life，inflammatory response factors，carotid artery plaque and adverse reactions of the 2 groups were compared.Results：The clinical effects of the observation group was better than that of the control group（P<0.05）.After treatment，the NIHSS score，CRP，IL-1 β，Hcy，IL-2，carotid intima-media thickness and atherosclerotic plaque index of the observation group were lower than those of the control group，and Barthel index was higher than that of the control group（all P<0.05）.There was no significant difference in the incidence of adverse reactions between the 2 groups（P>0.05）.Conclusion：For patients with ischemic stroke who successfully received rt-PA thrombolytic therapy during the window period，the combined therapy with ginkgo diterpene lactone meglumine injection can further enhance the therapeutic effect，improve neurological function and quality of life，and stabilize serology Indicators and carotid plaque conditions，and the safety of treatment is good.

Keywords Ginkgo diterpene lactone meglumine Injection; Ischemic stroke; Carotid plaque; Intravenous thrombolysis; Traditional Chinese medicine; Cardiovascular and cerebrovascular diseases; Speech function; Limb function

中图分类号：R278;R743.3文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.10.018

我国心脑血管疾病患者数量逐年增多，由此造成的人群健康威胁以及经济损失十分严重[1]。缺血性脑卒中在其中占有相当的比例，在目前我国人群的饮食结构改变，生活作息习惯不良化，心理压力增加，人口老龄化程度加大等诸多因素的影响下，缺血性脑卒中的发病率、致残率和病死率等指标逐年递增[2]。缺血性脑卒中的发病比较急，病情进展迅速，一般具有意识障碍、恶心、呕吐、眩晕、言语功能和肢体功能受损等表现。……