目的 探討注射用丹參多酚酸鹽聯(lián)合長(zhǎng)春西汀注射液治療腔隙性腦梗死的臨床療效。方法 選取2018年1月-2019年9月天津市環(huán)湖醫(yī)院收治的92例腔隙性腦梗死患者作為研究對(duì)象，按照隨機(jī)數(shù)字表法將全部患者分為對(duì)照組和治療組，每組各46例。對(duì)照組靜脈滴注長(zhǎng)春西汀注射液，30 mg/次，1次/d。治療組在對(duì)照組治療的基礎(chǔ)上靜脈滴注注射用丹參多酚酸鹽，200 mg/次，1次/d。兩組患者均連續(xù)治療2周。比較兩組患者治療后的總有效率，并比較兩組的神經(jīng)功能缺損程度、血流動(dòng)力學(xué)指標(biāo)、細(xì)胞因子水平。結(jié)果 在治療后，治療組患者的總有效率比對(duì)照組高，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的NIHSS評(píng)分明顯低于治療前（P<0.05）；治療后治療組的NIHSS評(píng)分比對(duì)照組低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的搏動(dòng)指數(shù)、阻力指數(shù)均明顯降低，平均血流速度明顯升高（P<0.05）；治療后治療組的搏動(dòng)指數(shù)、阻力指數(shù)比對(duì)照組低，平均血流速度比對(duì)照組高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的C反應(yīng)蛋白（CRP）、同型半胱氨酸（Hcy）、內(nèi)皮素-1（ET-1）水平均明顯低于治療前，一氧化氮（NO）明顯高于治療前（P<0.05）；治療后治療組的CRP、Hcy、ET-1水平均比對(duì)照組低，NO水平比對(duì)照組高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 注射用丹參多酚酸鹽聯(lián)合長(zhǎng)春西汀注射液可提高腔隙性腦梗死的療效，減輕神經(jīng)功能損傷，改善血流動(dòng)力學(xué)水平和細(xì)胞因子水平，具有一定的臨床研究?jī)r(jià)值。

Objective To investigate the clinical effect of Salvianolate for injection combined with Vinpocetine Injection in treatment of lacunar infarction. Methods Patients (92 cases) with lacunar infarction in Tianjin Huanhu Hospital from January 2018 to September 2019 were divided into control and treatment groups according to the random number table methods, and each group had 46 cases. Patients in the control group were iv administered with Vinpocetine Injection, 30 mg/time, once daily. Patients in the treatment group were iv administered with Salvianolate for injection on the basis of the control group, 200 mg/time, once daily. Patients in two groups were treated for 2 weeks. After treatment, the total effective rate was evaluated, and the degree of neurological deficit, hemodynamic index, and cytokine level in two groups before and after treatment were compared. Results The total effective rate in the treatment group was higher than that in the control group (P<0.05). After treatment, the NIHSS scores in two groups were significantly decreased (P<0.05), and the NIHSS scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, pulsation index and resistance index in two groups were significantly decreased but the average blood flow velocity was significantly increased (P<0.05). The pulsation index and resistance index in the treatment group were lower than those in the control group, but the average blood flow velocity in the treatment group was higher than that in the control group (P<0.05). After treatment, the levels of CRP, Hcy, and ET-1 in two groups were significantly decreased (P<0.05), and the levels of CRP, Hcy, and ET-1 in the treatment group were lower than those in the control group (P<0.05). Conclusion Salvianolate for injection combined with Vinpocetine Injection has clinical curative effect in treatment of lacunar infarction, can reduce the damage of nerve function and improve the levels of hemodynamics and cytokines, which has a certain clinical application value.

R971

天津市教委科研計(jì)劃項(xiàng)目（2018KJ009）