目的 探討腦蛋白水解物注射液聯(lián)合尿激酶治療急性腦梗死的臨床療效。方法 選取2015年1月—2017年8月在安徽醫(yī)科大學附屬巢湖醫(yī)院治療的急性腦梗死患者94例，隨機分為對照組（47例）和治療組（47例）。對照組靜脈滴注注射用尿激酶，100萬單位加入150 mL生理鹽水，30 min內(nèi)滴完，入院后1次；治療組在對照組的基礎(chǔ)上靜脈滴注注射用腦蛋白水解物，10 mL加入250 mL生理鹽水，1次/d。兩組均經(jīng)過14 d治療。觀察兩組患者臨床療效，比較治療前后兩組患者NIHSS評分、SF-36量表評分、血清學指標和腦血流動力學指標。結(jié)果 治療后，對照組臨床總有效率為80.85%，顯著低于治療組的95.74%，兩組比較差異具有統(tǒng)計學意義（P < 0.05）。治療后，兩組NIHSS評分明顯降低、SF-36量表各項目評分明顯升高，同組比較差異具有統(tǒng)計學意義（P < 0.05）；且治療組上述評分改善后水平明顯優(yōu)于對照組（P < 0.05）。治療后，兩組患者血清基質(zhì)金屬蛋白酶-9（MMP-9）、白細胞分化抗原40（CD40L）、氧化低密度脂蛋白和胱抑素C（CysC）均明顯降低（P < 0.05）；且治療組上述血清學指標明顯低于對照組（P < 0.05）。治療后，兩組患者平均血流量（Q_mean）和平均血流速度（V_mean）水平明顯升高，動態(tài)阻抗（DR）、腦血管特征性阻抗（ZCV）和腦血管外周阻力（R）水平明顯降低，同組比較差異具有統(tǒng)計學意義（P < 0.05）；且治療組上述腦血流動力學指標水平顯著優(yōu)于對照組（P < 0.05）。結(jié)論 腦蛋白水解物聯(lián)合尿激酶治療急性腦梗死可有效降低機體炎性反應，促進神經(jīng)功能恢復，改善腦血流動力學。

Objective To investigate the efficacy of cerebroprotein hydrolysate combined with urokinase in treatment of acute cerebral infarction. Methods Patients (94 cases) with acute cerebral infarction in Chaohu Hospital of Anhui Medical University from January 2015 to August 2017 were randomly divided into control (47 cases) and treatment (47 cases) groups. Patients in the control group were iv administered with Urokinase for injection, one million unit added into normal saline 150 mL, and dripped off in 30 min, 1 time after admission. Patients in the treatment group were iv administered with Cerebroprotein Hydrolysate for injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS scores, SF-36 scores, serological indexes and cerebral hemodynamic indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.85%, which was significantly lower than 95.74% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but SF-36 scores were significantly increased, and the difference was statistically significant in the same group (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the MMP-9, CD40L, oxygenized low density lipoprotein and CysC in two groups was significantly decreased (P < 0.05), and these serological indexes in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the Q_mean and V_mean levels in two groups were significantly increased, but DR, ZCV and R levels were significantly decreased, there were differences in the same group (P < 0.05), and the cerebral hemodynamic indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Cerebroprotein hydrolysate combined with urokinase in treatment of acute cerebral infarction can effectively reduce the inflammatory response, promote the recovery of neurological function and improve cerebral hemodynamics.