目的 探討醒腦靜注射液聯(lián)合纖溶酶治療急性腦梗死的臨床療效。方法 選取2012年7月—2015年1月重慶市巴南區(qū)第二人民醫(yī)院收治的急性腦梗死患者200例,隨機(jī)分為對照組和治療組,每組各100例。對照組在常規(guī)治療的基礎(chǔ)上靜脈滴注注射用纖溶酶,100 U加入到5%葡萄糖注射液250 mL中,1次/d。治療組在對照組的基礎(chǔ)上速度靜脈滴注醒腦靜注射液,20 mL/次,1次/d。兩組患者均治療12周。比較兩組的臨床療效、神經(jīng)功能缺損量表(NIHSS)以及日常生活活動(dòng)能力量表(ADL)評分、血液流變學(xué)指標(biāo)全血高切黏度(HBV)、全血低切黏度(LBV)、紅細(xì)胞壓積(HCT)、血漿黏度(SV)、纖維蛋白原(FIB)含量、血沉(ESR)以及血小板聚集率(PAR)的變化。結(jié)果 治療后,輕、中重度急性腦梗死患者治療組的總有效率均顯著高于對照組(P<0.05),且輕度患者的總有效率顯著高于中重度患者同組的總有效率(P<0.05)。輕、中重度急性腦梗死患者治療后的NIHSS、ADL評分均較同組治療前顯著改善,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);治療組的NIHSS評分降低程度更為明顯,比較差異具有顯著性(P<0.05);治療后,輕、中重度急性腦梗死患者治療組的NIHSS、ADL評分均較同程度患者對照組顯著改善,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。輕、中重度急性腦梗死患者治療組的NIHSS、ADL評分均較同程度患者對照組顯著改善,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組的HBV、LBV、HCT、FIB、SV、PAR均較同組治療前顯著改善,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);治療組治療后的HBV、HCT、FIB、SV、ESR、PAR均較對照組治療后顯著改善,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 醒腦靜注射液聯(lián)合纖溶酶治療急性腦梗死具有較好的臨床療效,可改善患者的神經(jīng)功能和生活質(zhì)量,能夠顯著改善血液流動(dòng)性指標(biāo),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Xingnaojing Injection combined with fibrinolysin in treatment of acute cerebral infarction. Methods Patients (200 cases) with acute cerebral infarction in Chongqing Banan District Second People's Hospital from July 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 100 cases. The patients in the control group were iv administered with Fibrinogenase for injection on the basis of conventional treatment, 100 U Fibrinogenase for injection added into 5% Glucose Injection 250 mL, once daily. The patients in the treatment group were iv administered with Xingnaojing Injection on the basis of the control group, 20 mL/time, once daily. The patients in two groups were treated for 12 weeks. After treatment, the efficacy was evaluated, and the changes of NIHSS scores, ADL scores, hemodynamic indexes high blood viscosity (HBV), low blood viscosity (LBV), hematocrit (HCT), plasma viscosity (SV), fibrinogen (FIB), blood sedimentation (ESR), and platelet aggregation rate (PAR) in two groups before and after treatment were compared. Results The clinical efficacy of patients with mild and moderately severe acute cerebral infarction in treatment group was higher than that in control group with significant difference (P < 0.05). And the efficacy of patients with mild acute cerebral infarction was higher than that of patients with moderately severe acute cerebral infarction in same group with significant difference (P < 0.05). After treatment, NIHSS and ADL scores of patients with mild and moderately severe acute cerebral infarction were improved compared with those of same group before treatment, and there were significant difference (P < 0.05). After treatment, NIHSS and ADL scores of patients with mild and moderately severe acute cerebral infarction in treatment group were improved more than those in control group with significant difference (P < 0.05). HBV, LBV, HCT, FIB, SV, and PAR of two groups were improved more than those in same group after treatment with significant difference (P < 0.05). HBV, HCT, FIB, SV, ESR, and PAR in treatment group were improved more than those in control group after treatment with significant difference (P < 0.05). Conclusion Xingnaojing Injection combined with fibrinolysin has clinical curative effect in treatment of acute cerebral infarction, and can improve nerve function and quality of life, significantly improve hemodynamic indexes, which has a certain clinical application value.