摘要目的 探讨银杏叶提取物对缺血性脑卒中患者颈动脉狭窄程度及血流动力学的影响.方法 以2012年2月至2014年1月新疆医科大学第一附属医院收治的缺血性脑卒中患者70例为研究对象,按随机数字法分为对照组(n=35)与观察组(n=35).对照组采取常规对症支持治疗,观察组在对照组基础上使用银杏叶提取物进行治疗,疗程均为2周.治疗后评价两组患者的临床疗效,记录治疗过程中不良反应的发生情况.比较治疗前后两组患者的颈动脉狭窄程度及血流动力学指标.结果 治疗后观察组和对照组的有效率分别为85.7％(30/35)、62.9％(22/35),组间比较差异有统计学意义(x2=4.79,P＜0.05).两组患者治疗期间均未出现肝、肾功能损伤等严重不良反应.与治疗前比较,治疗后两组患者颈动脉管腔狭窄比均显著下降(均P＜0.05).与对照组比较,治疗后观察组患者颈动脉管腔狭窄比显著降低(P＜0.05).与治疗前比较,治疗后两组患者颈动脉血流平均流速(Vm)、最大峰值流速(Vs)均显著增加,而血管阻力指数(RI)及搏动指数(PI)均显著降低(均P＜0.05).与对照组比较,治疗后观察组患者Vm、Vs均显著增加,RI、PI均显著降低(均P＜0.05).结论 银杏叶提取物能减轻缺血性脑卒中患者的颈动脉狭窄程度,改善颈动脉血流动力学,促进脑血流灌注恢复.

abstractsObjective To investigate the effects of Ginkgo biloba extract on the severity of carotid stenosis and hemodynamics in patients with ischemic stroke.Methods Seventy patients with ischemic stroke hospitalized in The First Affiliated Hospital of Xinjiang Medical University between February 2012 and January 2014 were included as the subjects in this study,and were randomly divided into the control group (n=35) and study group (n=35).The control group received conventional symptomatic treatment,and the study group received Ginkgo biloba extract in addition to the treatment for the control group,with a course of 2 weeks.The clinical efficacy in the two groups after the treatment was evaluated.Adverse reactions during the treatment were recorded.The severity of carotid stenosis and hemodynamics of the two groups before and after the treatment were compared.Results After the treatment,the effective rates of the study group and the control group were 85.7％ (30/35) and 62.9％ (22/35),respectively,with significant differences between the two groups (x2=4.79,P＜0.05).There were no liver and renal damage and other serious adverse reactions in the two groups during the treatment.The rate of carotid stenosis in the two groups after treatment were significantly decreased compared with the baselines (both P＜0.05).And compared with the control group,the rate of carotid stenosis in the study group was decreased after treatment (P＜0.05).Compared with the baselines,the carotid mean flow velocity (Vm) and the maximum peak velocity (Vs) were significantly increased,whereas the vascular resistance index (RI) and pulsatility index (PI) were significantly decreased in the two groups after treatment (all P＜0.05).Compared with the control group,the Vm and Vs were significantly increased,and the RI and PI were significantly decreased in the study group after treatment (all P＜0.05).Conclusion Ginkgo biloba extract can significantly reduce the severity of carotid stenosis,improve carotid hemodynamics,and promote the recovery of cerebral blood flow perfusion in patients with ischemic stroke.