目的 探討尼麥角林片聯(lián)合降纖酶注射液治療短暫性腦缺血發(fā)作的臨床療效。方法 選取2018年3月-2018年12月在四川大學(xué)華西醫(yī)院治療的短暫性腦缺血發(fā)作患者236例，根據(jù)用藥的差別分為對照組和治療組，每組各118例。對照組靜脈滴注降纖酶注射液，2 mL/次加入生理鹽水250 mL，1次/d；治療組在對照組基礎(chǔ)上口服尼麥角林片，5 mg/次，3次/d。兩組患者經(jīng)2周治療。觀察兩組患者臨床療效，同時比較治療前后兩組患者ABCD2、ESRS和SPI-Ⅱ評分，及基質(zhì)金屬蛋白酶9（MMP-9）、血管緊張素Ⅱ（Ang-Ⅱ）、同型半胱氨酸（Hcy）、趨化因子CXCL12、可溶性血管細(xì)胞黏附因子1（sVCAM-1）、血漿黏度（SV）、全血高切黏度（HBV）、全血低切黏度（LBV）、纖維蛋白原（FIB）及血小板聚集率（PAR）、血小板膜糖蛋白CD63、血小板膜糖蛋白CD62P和血小板膜糖蛋白纖維蛋白原受體（PAC-1）水平。結(jié)果 治療后，對照組臨床有效率為84.75%，顯著低于治療組的97.46%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組ABCD2評分、ESRS評分、SPI-Ⅱ評分均明顯下降（P<0.05），且治療組患者這些評分顯著低于對照組（P<0.05）。治療后，兩組患者M(jìn)MP-9、Ang-II、Hcy、CXCL12、sVCAM-1、FIB、LBV、HBV、SV、PAR、CD63、CD62P、PAC-1水平均顯著降低（P<0.05），且治療組患者這些指標(biāo)水平顯著低于對照組（P<0.05）。結(jié)論 尼麥角林片聯(lián)合降纖酶注射液治療短暫性腦缺血發(fā)作效果顯著，可有效預(yù)防腦卒中的發(fā)生，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of niergoline combined with defibrase in treatment of transient ischemic attack. Methods Patients (236 cases) with transient ischemic attack in West China Hospital, Sichuan University from March 2018 to December 2018 were divided into control and treatment groups based on different treatments, and each group had 118 cases. Patients in the control group were iv administered with Defibrase Injection, 2 mL added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Nicergoline Tablets on the basis of the control group, 5 mg/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the ABCD2、ESRS and SPI-Ⅱ scores, the levels of MMP-9, Ang-II, Hcy, CXCL12, sVCAM-1, FIB, LBV, HBV, SV, PAR, CD63, CD62P and PAC-1 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 84.75%, which was significantly lower than 97.46% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the ABCD2, ESRS, and SPI-Ⅱ scores in two groups were significantly decreased (P<0.05), and these scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of MMP-9, Ang-II, Hcy, CXCL12, sVCAM-1, FIB, LBV, HBV, SV, PAR, CD63, CD62P, and PAC-1 in two groups were significantly decreased (P<0.05), and the indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Niergoline combined with defibrase in treatment of transient ischemic attack has a significant effect, can effectively prevent the stroke, which has a certain clinical application value.

R971