银杏叶提取物联合倍他司汀治疗老年脑血栓临床观察
高 霞 黄鹤鸣 陈 实
深圳市人民医院 暨南大学第二临床医学院 南方科技大学第一附属医院，广东 深圳 518000
通信作者：高霞
【摘要】 目的 探讨银杏叶提取物联合倍他司汀治疗老年脑血栓的效果及对氧化型低密度脂蛋白（ox-LDL）、一氧化氮（NO）的影响。方法 前瞻性纳入深圳市人民医院 2019-05—2021-05 收治的 120 例老年脑血栓患者为研究对象，随机分为对照组和联合组各 60 例。对照组给予倍他司汀治疗，联合组给予银杏叶提取物联合倍他司汀治疗，比较 2 组临床效果。结果 治疗后 2 组双侧颈总动脉（CCA）、颈动脉分叉处（BIF）的稳定斑块和不稳定斑块均缩小，且联合组较对照组更低（P<0.05）。治疗后 2 组血清肿瘤坏死因子-α（TNF-α）、超敏 C 反应蛋白（hs-CRP）、内皮素-1（ET-1）、基质金属蛋白酶-2（MMP-2）、NO、ox-LDL 水平均降低，且联合组较对照组更低（P<0.05）。治疗后 2 组血管内皮生长因子（VGEF）水平均升高，且联合组较对照组更高（P<0.05）。治疗后 2 组改良 Rankin 量表评分均降低，且联合组低于对照组（P<0.05），2 组 Barthel 指数评分均升高，且联合组较对照组更高（P<0.05）。联合组不良反应发生率（21.28%）与对照组（17.02%）比较差异无统计学意义（P>0.05）。结论 银杏叶提取物联合倍他司汀可减小老年脑血栓患者的颈动脉粥样硬化斑块，扩张血管，改善神经功能和生活自理能力，降低 ox-LDL、NO表达。
【关键词】 脑血栓；银杏叶提取物；倍他司汀；老年；氧化型低密度脂蛋白；一氧化氮
【中图分类号】 R743.32 【文献标识码】 A 【文章编号】 1673-5110 （2022） 05-0609-05
基金项目：国家自然科学基金（编号：82071193）
DOI：10.12083/SYSJ.220274
Clinical observation of ginkgo biloba extract combined with betahistine in the treatment of senile cerebral thrombosis
GAO Xia，HUANG Heming，CHEN Shi
Shenzhen Municipal People’s Hospital/2ND Clinical Medical College of JINAN University/1ST Affiliated Hospital of Southern University of Science and Technology，Shenzhen 518000，China
Corresponding author：GAO Xia
【Abstract】 Objective To investigate the clinical effect of ginkgo biloba extract combined with betahistine in the treatment of senile cerebral thrombosis and the effect of oxidized low-density lipoprotein（ox-LDL）and nitric oxide（NO）. Methods A total of 120 elderly patients with cerebral thrombosis admitted to our hospital from May 2019 to May 2021 were selected as the research objects，and they were randomly divided into the control group and the combined group，60 cases in each group. The control group was treated with betahistine，and the combined group was treated with ginkgo biloba leaf extract combined with betahistine. The clinical effects of the two groups were compared. Results After treatment，the area of stable plaque and unstable plaque at bilateral common carotid artery（CCA）and carotid artery bifurcation（BIF）was reduced in both groups，and lower in combined group than in control group （P<0.05）. After treatment，the serum levels of tumor necrosis factor-α （TNF-α），hypersensitive C-reactive protein（hs-CRP），endothelin-1（ET-1），vascular endothelial growth factor（VGEF），matrix metalloproteinase-2 （MMP-2），NO and ox-LDL in 2 groups were decreased，and those in combined group were lower than those in control group（P<0.05）. After treatment，the level of VGEF in both groups was increased，and the level in combined group was higher than that in control group（P<0.05）. After treatment，the scores of modified Rankin scale decreased in both groups，and the combined group was lower than the control group（P<0.05）. Barthel index scores were higher in both groups，and higher in combined group than in control group（P<0.05）. The incidence of adverse reactions in combination group（21.28%）and control group （17.02%） had little difference （P>0.05）. Conclusion Ginkgo biloba extract combined with betahistine can reduce carotid atherosclerotic plaque，dilate blood vessels，improve nerve function and self-care ability，and reduce the expression levels of ox-LDL and NO in elderly patients with cerebral thrombosis.
【Key words】 Neurodegenerative diseases；Alzheimer’s disease；Parkinson’s disease；Multiple system atrophy；Huntington’s disease；5-hydroxymethylcytosine；TET family proteins；Epigenetics
