Abstract:

Objective　To explore the efficacy and safety of dihydroergotoxine combined with ginkgo biloba extract injection for elderly patients with ischemic cerebrovascular disease. Methods　In this prospective study, 90 elderly patients with ischemic cerebrovascular disease treated at Department of Neurology, Xi'an Gaoxin Hospital from March 2021 to January 2023 were divided into a control group and an observation group according to the treatment order, with 45 cases in each group. There were 25 males and 20 females in the observation group; they were 67-76 (69.72±4.03) years old. There were 22 males and 23 females in the control group; they were 66-78 (69.58±4.26) years old. Both groups were routinely treated; in addition, the observation group were treated with dihydroergotoxine and ginkgo biloba extract injection, and the control group with dihydroergotoxine. Both groups were treated for 2 weeks. The hemodynamic and cerebral blood flow indicators (blood low shear viscosity, blood high shear viscosity, and plasma viscosity), brain blood flow indicators (cerebrovascular peripheral resistance and end diastolic blood flow velocity of carotid artery), and scores of National Institute of Health Stroke Scale (NIHSS) and Activities of Daily Living (ADL) after the treatment in both groups were recorded and compared. The clinical efficacies and incidences of adverse reactions were compared between the two groups. χ² and t tests were used. Results　After the treatment, the blood low shear viscosity, blood high shear viscosity, and plasma viscosity in the observation group were lower than those in the control group [(7.13±1.21) mPa·s vs. (8.26±1.46) mPa·s, (4.89±0.88) mPa·s vs. (5.78±1.04) mPa·s, and (1.59±0.31) mPa·s vs. (1.86±0.34) mPa·s], with statistical differences (t=4.00, 4.38, and 3.94; all P<0.05). The end diastolic blood flow velocity of carotid artery and cerebrovascular peripheral resistance in the observation group were better than those in the control group [(96.48±5.31)cm/s vs. (89.46±4.82) cm/s and (1.68±0.23) kPa·s/ml vs.(1.96±0.25) kPa·s/ml], with statistical differences (t=6.57 and 5.53; both P<0.05). After the treatment, the scores of ADL and NIHSS in the observation group were better than those in the control group [(69.74±5.19) vs. (56.64±5.33) and (5.12±1.13) vs. (8.18±1.45)], with statistical differences (t=11.81 and 11.17; both P<0.05). The total effective rate in the observation group was higher than that in the control group [91.11% (41/45) vs. 73.33% (33/45)], with a statistical difference (χ²=4.87; P<0.05). There was no statistical difference in the total incidence of adverse reactions during the treatment between the observation group and the control group [6.67% (3/45) vs. 8.89% (4/45); χ²=0.16; P>0.05]. Conclusion　In the treatment of elderly Patients with ischemic cerebrovascular disease, the combination of dihydroergotoxine and ginkgo biloba extract injection demonstrates significant clinical efficacy and good safety.

Key words:

Cerebral ischemia, Transient ischemic attack, Dihydroergotoxine, Ginkgo biloba extract, Ischemic cerebrovascular disease, Elderly patients

摘要：

目的　探讨丁苯酞联合银杏叶提取物注射液对老年缺血性脑血管病患者的疗效与安全性。方法　前瞻性研究，选取2021年3月至2023年1月西安高新医院神经内科诊治的90例老年缺血性脑血管病患者为研究对象，按诊治先后顺序分为对照组和观察组。观察组中男性25例，女性20例，年龄67～76（69.72±4.03）岁，在常规治疗的基础上采用丁苯酞联合银杏叶提取物注射液；对照组中男性22例，女性23例，年龄66～78（69.58±4.26）岁，在常规治疗的基础上服用丁苯酞。两组均接受2周治疗，记录并比较治疗后两组患者的血流动力学指标（全血低切黏度、全血高切黏度和血浆黏度）、脑血流指标（脑血管外周阻力和颈动脉舒张期末血流速度）、美国国立卫生研究院卒中量表（NIHSS）以及日常生活活动（ADL）评分，评估临床疗效及治疗期间不良反应发生情况。统计学方法采用χ²检验、t检验。结果　治疗后，观察组全血低切黏度、全血高切黏度和血浆黏度均低于对照组［（7.13±1.21）mPa·s比（8.26±1.46）mPa·s、（4.89±0.88）mPa·s比（5.78±1.04）mPa·s、（1.59±0.31）mPa·s比（1.86±0.34）mPa·s］，差异均有统计学意义（t=4.00、4.38、3.94，均P<0.05）。治疗后，观察组颈动脉舒张期末血流速度高于对照组，脑血管外周阻力低于对照组［（96.48±5.31）cm/s比（89.46±4.82）cm/s、（1.68±0.23）kPa·s/ml比（1.96±0.25）kPa·s/ml］，差异均有统计学意义（t=6.57、5.53，均P<0.05）。治疗后，观察组ADL评分高于对照组，NIHSS评分低于对照组［（69.74±5.19）分比（56.64±5.33）分、（5.12±1.13）分比（8.18±1.45）分］，差异均有统计学意义（t=11.81、11.17，均P<0.05）。观察组总有效率高于对照组［91.11%（41/45）比73.33%（33/45）］，差异有统计学意义（χ²=4.87，P<0.05）。治疗期间，观察组不良反应总发生率为6.67%（3/45），对照组为8.89%（4/45），差异无统计学意义（χ²=0.16，P>0.05）。结论　在老年患者缺血性脑血管病的治疗中，丁苯酞联合银杏叶提取物注射液表现出显著的临床效果，而且具备良好的安全性。

关键词:

脑缺血, 短暂性脑缺血发作, 丁苯酞, 银杏叶提取物, 缺血性脑血管病, 老年患者