目的 探討丹參川芎嗪注射液聯(lián)合阿加曲班治療急性腦梗死的臨床療效。方法 選取2014年5月—2017年5月在天津市北辰醫(yī)院治療的急性腦梗死患者74例，根據(jù)用藥的差別分為對(duì)照組（37例）和治療組（37例）。對(duì)照組靜脈滴注阿加曲班注射液，30 mg加入5%葡萄糖溶液250 mL，持續(xù)24 h，治療2 d后20 mg加入5%葡萄糖溶液250 mL，2次/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注丹參川芎嗪注射液，10 mL加入5%葡萄糖溶液250 mL，1次/d。兩組均治療兩周。觀察兩組患者臨床療效，比較治療前后兩組患者國(guó)立衛(wèi)生研究院卒中量表（NIHSS）、BI指數(shù)、mRS評(píng)分、血清學(xué)指標(biāo)和血液流變學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組臨床有效率分別為81.08%和94.59%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組NIHSS評(píng)分和mRS評(píng)分明顯降低，BI指數(shù)評(píng)分明顯升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述評(píng)分改善后水平明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組血清肽素（CPP）、親環(huán)素A（CyPA）、心臟型脂肪酸結(jié)合蛋白（H-FABP）水平顯著降低，胰島素樣生長(zhǎng)因子1（IGF-1）和腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）顯著增加，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組血清學(xué)指標(biāo)明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組紅細(xì)胞壓積（HCT）、全血粘度（WBV）、纖維蛋白原（FIB）和血漿黏度（PV）水平均明顯降低（P<0.05）；且治療組上述血液流變學(xué)指標(biāo)顯著低于對(duì)照組（P<0.05）。結(jié)論 丹參川芎嗪注射液聯(lián)合阿加曲班治療急性腦梗死可有效改善機(jī)體血液流變學(xué)指標(biāo)，降低機(jī)體炎癥反應(yīng)、促進(jìn)神經(jīng)功能恢復(fù)和改善日?；顒?dòng)能力。

Objective To explore the clinical efficacy of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with argatroban in treatment of acute cerebral infarction. Methods Patients (74 cases) with acute cerebral infarction in Tianjin Beichen Hospital from May 2014 to May 2017 were divided into control (37 cases) and treatment (37 cases) based on different treatment. Patients in the control group were iv administered with Argatroban Injection, 30 mg added into 5% glucose solution 250 mL for 24 h, then 20 mg added into 5% glucose solution 250 mL after treated for 2 d, twice daily. Patients in the treatment group were iv administered with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of the control group, 10 mg added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, the NIHSS, BI indexes and mRS scores, the serological indexes and hemorheological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.08% and 94.59% respectively, and there were differences between two groups (P < 0.05). After treatment, the NIHSS and mRS scores in two groups were significantly decreased, BI indexes scores was significantly increased, and there were differences 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 CPP, CyPA and H-FABP levels in two groups were significantly decreased, IGF-1 and BDNF levels were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these serological indexes levels in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the HCT, WBV, FIB and PV levels in two groups were significantly decreased (P < 0.05). And the hemorheological indexes levels in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with argatroban in treatment of acute cerebral infarction can effectively improve hemorheological indexes, reduce inflammation, promote the recovery of neurological function and improve the ability of daily activities.