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目的探讨银杏酮酯滴丸联合阿托伐他汀钙治疗缺血性脑梗死的临床疗效。方法选取2012年8月—2015年1月上海市奉贤区中心医院收治的急性缺血性脑梗死患者120例,随机分为对照组和治疗组,每组各60例。对照组口服阿托伐他汀钙片,1片/次,1次/d。治疗组在对照组治疗基础上口服银杏酮酯滴丸,5丸/次,3次/d。两组患者均治疗2周,出院后坚持服药12周。观察两组的临床疗效,比较两组治疗前后神经功能缺损(NIHSS)评分、巴特尔日常生活能力指数(BI)、颈动脉内膜–中膜厚度值(IMT)、斑块面积和个数、细胞间黏附分子-1(ICAM-1)和血管细胞黏附分子-1(VCAM-1)的变化。结果治疗后,对照组和治疗组的总有效率分别为76.67%、91.67%,两组总有效率比较差异有统计学意义(P<0.05)。治疗2周、出院12周时,两组NIHSS评分、IMT、斑块面积、斑块个数、s ICAM-1、s VCAM-1均显著降低,BI指数显著升高,同组治疗前后差异有统计学意义(P<0.05);且治疗组的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论银杏酮酯滴丸联合阿托伐他汀钙治疗缺血性脑梗死具有较好的临床疗效,可改善患者的神经功能和生活质量,能够显著降低黏附分子的表达,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of Ginkgo Biloba Dropping Pill combined with atorvastatin calcium on ischemic cerebral infarction. Methods 120 patients with acute ischemic cerebral infarction admitted to Shanghai Fengxian Central Hospital from August 2012 to January 2015 were randomly divided into control group and treatment group, 60 cases in each group. Control group oral atorvastatin calcium tablets, 1 / time, 1 time / d. Treatment group in the control group based on oral ginkgo pills, 5 pills / time, 3 times / d. Two groups of patients were treated for 2 weeks, insisted on medication for 12 weeks after discharge. The clinical efficacy of the two groups were observed. The NIHSS score, Bartlett’s daily living ability index (BI), carotid artery intima-media thickness (IMT), plaque area and number, (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were detected by flow cytometry. Results After treatment, the total effective rates of the control group and the treatment group were 76.67% and 91.67%, respectively. There was significant difference between the two groups in the total effective rate (P <0.05). NIHSS score, IMT, plaque area, plaque number, s ICAM-1, s VCAM-1 were significantly decreased and BI index were significantly increased in the two groups after treatment for 2 weeks and 12 weeks after discharge. There was significant difference between before and after treatment in the same group (P <0.05). The improvement of the treatment group was better than that of the control group. The difference between the two groups was statistically significant (P <0.05). Conclusion Ginkgo biloba pills combined with atorvastatin calcium treatment of ischemic cerebral infarction has a good clinical efficacy, can improve the patient’s neurological function and quality of life, can significantly reduce the expression of adhesion molecules, has some clinical application value .