目的 探討銀杏內(nèi)酯注射液聯(lián)合替格瑞洛治療急性基底動(dòng)脈閉塞性腦梗死的療效。方法 納入2022年8月—2024年8月滄州市人民醫(yī)院神經(jīng)內(nèi)科收治的80例急性基底動(dòng)脈閉塞性腦梗死患者，均接受支架取栓治療。根據(jù)干預(yù)方案差異將病例分為對(duì)照組（n=40）和治療組（n=40）。對(duì)照組口服替格瑞洛片，90 mg/次，1日2次。治療組在對(duì)照組標(biāo)準(zhǔn)化治療基礎(chǔ)上聯(lián)合應(yīng)用銀杏內(nèi)酯注射液，每日10 mL與250 mL生理鹽水混合后靜脈滴注。兩組干預(yù)周期均持續(xù)14 d。觀察兩組患者臨床療效，比較治療前后兩組患者巴塞爾指數(shù)（BI）評(píng)分、血管再通分級(jí)（MTICI）評(píng)分和美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分，血清重組人泛素羧基末端水解酶L1（UCH-L1）、人成纖維細(xì)胞生長(zhǎng)因子4（FGF4）和神經(jīng)元PAS結(jié)構(gòu)域蛋白4（NPASDP4）水平，及并發(fā)癥情況。結(jié)果 療效分析結(jié)果顯示，治療組總有效率85.00%，顯著高于常規(guī)對(duì)照組的65.00%（P＜0.05）。神經(jīng)功能恢復(fù)指標(biāo)方面，兩組Barthel指數(shù)與MTICI分級(jí)均呈現(xiàn)顯著升高，而NIHSS評(píng)分均呈現(xiàn)顯著降低，其中治療組各指標(biāo)改善幅度相較對(duì)照組更為突出（P＜0.05）。神經(jīng)損傷相關(guān)生物標(biāo)志物方面，治療后，兩組血清UCH-L1、FGF4和NPASDP4水平較治療前顯著降低（P＜0.05），且治療組各指標(biāo)水平明顯低于對(duì)照組（P＜0.05）。治療期間及療程結(jié)束后1個(gè)月內(nèi)對(duì)照組和治療組患者并發(fā)癥發(fā)生率分別為20.00%和5.00%，治療組并發(fā)癥發(fā)生率明顯低于對(duì)照組（P＜0.05）。結(jié)論 銀杏內(nèi)酯注射液聯(lián)合替格瑞洛治療急性基底動(dòng)脈閉塞性腦梗死血管再通效果顯著，不僅能大幅改善患者神經(jīng)功能缺損程度和自我護(hù)理能力，而且還能有效促進(jìn)血清學(xué)相關(guān)指標(biāo)恢復(fù)并降低并發(fā)癥發(fā)生率。

Objective To evaluate the therapeutic efficacy of Ginkgolide Injection combined with Ticagrelor in treatment of acute basilar artery occlusive cerebral infarction. Methods A total of 80 patients with acute basilar occlusive cerebral infarction admitted to the Department of Neurology of Cangzhou People's Hospital from August 2022 to August 2024 were included, all of whom received stent thrombectomy. The patients were divided into control group (n=40) and treatment group (n=40). Patients in the control group were po administered with Ticagrelor Tablets, 90 mg/time, once daily. Patients in the treatment group were iv administered with Ginkgolide Injection on the basis of the control group, 10 mL was added into 250 mL normal saline, once daily. Both groups completed 14 d therapeutic cycles. Patients in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, and the scores of Barthel index, MTICI and NIHSS, the levels of UCH-L1, FGF4 and NPASDP4, and the incidence of complications in two groups before and after treatment were compared. Results After treatment, the results of curative effect analysis showed that the total effective rate of the treatment group was 85.00%, which was significantly higher than that of the conventional control group (65.00%, P < 0.05). In terms of neurological function recovery indexes, BI and MTICI grades were significantly increased in both groups, while NIHSS scores were significantly decreased, and the improvement of indexes in the treatment group was more prominent than that in the control group (P < 0.05). In terms of biomarkers associated with nerve damage, after treatment, the serum levels of UCH-L1, FGF4 and NPASDP4 in two groups were significantly lower than those before treatment (P < 0.05), and the levels of each indicator in the treatment group were significantly lower than those in the control group (P < 0.05). The incidence of complications in the control group and treatment group during the treatment period and within 1 month after the end of the treatment course were 20.00% and 5.00% respectively, and the difference between two groups was statistically significant (P < 0.05). Conclusion Ginkgolide Injection combined with ticagrelor has a significant effect on acute basilar artery occlusive stroke demonstrates significant vascular recanalization, which can not only markedly improve the degree of neurological impairment and self-care ability of patients but also effectively promote the recovery of serum-related indicators and reduce the incidence of complications.

R971

滄州市科技計(jì)劃自籌經(jīng)費(fèi)項(xiàng)目（222106037）