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目的:观察银杏达莫对高血压脑出血(HICH)神经功能恢复的作用及对血浆神经元特异性烯醇化酶(NSE)含量、血清补体C3,C4含量及超敏C-反应蛋白(hs-CRP)的影响。方法:84例HICH患者随机按入院前后顺序分为对照组和观察组各42例。两组均行CT引导下行微创碎吸术,术后给予脱水降颅压、控制血压、防治感染、营养神经、对症等西医基础治疗。观察组加用银杏达莫注射液,每次20 m L,静脉滴注,2次/d。两组疗程均为14 d。进行治疗前后美国国立卫生院神经功能缺损(NIHSS)评分、格拉斯哥昏迷评分(GCS)评分和运动功能评价量表(Fugl-Meyer)评分;检测治疗前后血浆NSE,血清C3,C4及hs-CRP水平。于治疗前、治疗后7,14 d进行NIHSS、格拉斯哥昏迷指数(GCS)和运动功能评价量表(Fugl-Meyer)评分;采用核磁共振成像(MRI)检查评估治疗前后中线结构移位情况;检测治疗后血浆神经元特异性烯醇化酶(NSE)含量、hsCRP、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平。结果:经Ridit分析,治疗后观察组临床疗效优于对照组(P<0.05);观察组NIHSS和GCS评分低于对照组(P<0.01);治疗后观察组Fugl-Meyer评分高于对照组(P<0.01);观察组的中线结构移位情况改善优于对照组(P<0.01);治疗后观察组NSE,hs-CRP,IL-6和TNF-α水平低于对照组(P<0.01)。结论:在西医常规治疗的基础上,银杏达莫注射液用于HICH微创术后患者能改善神经缺损功能,促进患者觉醒,其作用机制可能是通过减轻脑水肿和炎症反应来实现的。
OBJECTIVE: To observe the effect of Ginkgo biloba on the recovery of neurological function in patients with hypertensive intracerebral hemorrhage (HICH) and to investigate the effect of ginkgoldol on neuronal-specific enolase (NSE), serum C3, C4 and hs- CRP). Methods: Eighty-four patients with HICH were randomly divided into control group and observation group according to the order of admission. Both groups underwent CT guided minimally invasive aspiration, postoperative dehydration reduced intracranial pressure, blood pressure control, prevention and treatment of infection, neurotrophic and symptomatic treatment of Western medicine. The observation group plus Yinxingdamo injection, each 20 m L, intravenous infusion, 2 times / d. The two courses of treatment were 14 d. National Institutes of Health neurological deficit (NIHSS) score, Glasgow Coma Scale (GCS) score and Motor Function Assessment Scale (Fugl-Meyer) score before and after treatment. The levels of plasma NSE, serum C3, C4 and hs-CRP . The NIHSS, Glasgow coma index (GCS) and motor function evaluation scale (Fugl-Meyer) were measured before treatment and 7,14 days after treatment. The midline structure shift was evaluated by MRI. After treatment, the levels of plasma neuron specific enolase (NSE), hsCRP, tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were measured. Results: Ridit analysis showed that the clinical efficacy of the observation group was better than that of the control group (P <0.05); NIHSS and GCS scores of the observation group were lower than those of the control group (P <0.01); Fugl-Meyer score of the observation group was higher than that of the control group (P <0.01). The midline structure shift in the observation group was better than that in the control group (P <0.01). The levels of NSE, hs-CRP, IL-6 and TNF-α in the observation group were lower than those in the control group 0.01). Conclusion: Based on the conventional treatment of western medicine, Yin Xing Damo injection for HICH minimally invasive surgery patients can improve the function of nerve defects and promote the patient awakening, the mechanism may be through relieving cerebral edema and inflammatory response to achieve.