静脉溶栓后应用EGB-761联合替罗非班治疗急性脑梗死的效果及其机制OA

Objective:To observe the efficacy of Ginkgo biloba extract(EGB)-761 combined with tirofiban hydrochloride injection in the treatment of acute cerebral infarction after intravenous thrombolysis,and to explore its effects on serum homocysteine(Hcy),vascular endothelial growth factor(VEGF)level,and activated coagulation factor Ⅶ/coagulation factor Ⅶ antigen(FⅦa/FⅦAg)ratio. Methods:A total of 368 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Henan University from January 2022 to December 2022 were selected as the study subjects.According to the admission sequence,the patients were divided into an observation group and a control group using the odd-even number grouping method.Both groups received intravenous thrombolysis,and the control group received tirofiban hydrochloride injection treatment,while the observation group received combined treatment with EGB-761 on the basis of the control group.The differences in Hcy,FⅦa/FⅦAg ratio,VEGF,chemokine CXC ligand(CXCL-12),and middle cerebral artery blood flow indexes were compared between the 2 groups.The plaque number and area,Barthel index(BI),and diffusion-weighted imaging and early CT in the Alberta Stroke Program Score(DWI-ASPECTS)were evaluated,and the efficacy of the 2 groups was statistically analyzed. Results:Before treatment,there was no statistical difference in Hcy,FⅦa/FⅦAg ratio,VEGF,and CXCL-12 between the 2 groups(all P＞0.05).Compared with before treatment,the levels of Hcy,FⅦa/FⅦAg ratio,and CXCL-12 decreased in both groups after treatment,and which were lower in the observation group than those in the control group(all P＜0.01).The VEGF levels increased in both groups after treatment,and which were higher in the observation group than those in the control group(both P＜0.01).Before the treatment,there was no statistically significant difference in the number and area of plaques,and middle cerebral artery blood flow indexes between the 2 groups(all P＞0.05).Compared with before treatment,the number and area of plaques,and middle cerebral artery pulsatility index(PI)decreased in both groups after treatment,and which were lower in the observation group than those in the control group(all P＜0.01).The mean blood flow velocity(Vm)and end-diastolic blood flow velocity(Vd)of the middle cerebral artery increased in both groups,and which were higher in the observation group than those in the control group(all P＜0.01).The total effective rate in the observation group was 95.21%(179/188),which was higher than 89.44%(161/180)in the control group,and the difference was statistically significant(P＜0.05).Before treatment,there was no statistical difference in BI and DWI-ASPECTS between the 2 groups(both P＞0.05).Compared with before treatment,the BI and DWI-ASPECTS of both groups increased after treatment,and which were higher in the observation group than those in the control group(all P＜0.01). Conclusion:Application of EGB-761 combined with tirofiban hydrochloride injection after intravenous thrombolysis for acute cerebral infarction could improve patients'quality of life via regulating serum Hcy and VEGF expression and FⅦa/FⅦAg ratio,increasing cerebral blood flow,and reducing carotid plaque.