目的 探討銀杏蜜環(huán)口服溶液聯(lián)合注射用阿替普酶治療急性腦梗死的臨床療效。方法 選取2017年1月-2019年1月天津市寧河區(qū)醫(yī)院的96例急性腦梗死患者研究對象，使用隨機數(shù)字表法將患者分為對照組和治療組，每組各48例。對照組患者給予注射用阿替普酶，0.9 mg/kg，其中10%靜脈推注，剩余的90%在1 h內(nèi)靜脈滴注。治療組在對照組治療的基礎上口服銀杏蜜環(huán)口服溶液，10 mL/次，3次/d。兩組患者治療14 d。觀察兩組的臨床療效，比較兩組的美國國立衛(wèi)生院神經(jīng)功能缺損評分（NIHSS）評分、歐洲生活質(zhì)量量表（EuroQOL）評分、血清神經(jīng)功能相關因子、血液流變學指標、血管內(nèi)皮功能指標。結果 治療后，對照組和治療組的總有效率分別為77.08%、91.67%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的NIHSS和EuroQOL評分顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療后治療組的NIHSS和EuroQOL評分均明顯低于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組血清神經(jīng)元特異性烯醇化酶（NSE）、同型半胱氨酸（Hcy）、S100β蛋白（S100β）水平均明顯降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療后治療組血清NSE、Hcy、S100β水平均明顯低于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的血漿黏度、全血高切黏度、全血低切黏度均明顯降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療后治療組的血漿黏度、全血高切黏度、全血低切黏度均明顯低于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組血清內(nèi)皮素-1（ET-1）水平明顯降低，血清一氧化氮（NO）水平明顯升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療后治療組血清ET-1水平明顯低于對照組，血清NO水平明顯高于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。結論 銀杏蜜環(huán)口服溶液聯(lián)合注射用阿替普酶治療急性腦梗死具有較好的臨床療效，能夠促進神經(jīng)功能的恢復，改善血液流變學和血管內(nèi)皮功能，提高患者的生活質(zhì)量，具有一定的臨床推廣應用價值。

Objective To explore the clinical efficacy of Ginkgo Leaf Extract and Armillariella Mellea Powders Oral Solution combined with Alteplase for injection in treatment of acute cerebral infarction. Methods Patients (96 cases) with acute cerebral infarction in Tianjin Ninghe Hospital from January 2017 to January 2019 were divided into control and treatment groups according to random number table method, and each group had 48 cases. Patients in the control group were given Alteplase for injection, 0.9 mg/kg, 10% of this dose were injected intravenously, and the remaining 90% were intravenously injected in 1 h. Patients in the treatment group were po administered with Ginkgo Leaf Extract and Armillariella Mellea Powders Oral Solution on the basis of the control group, 10 mL/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS scores, EuroQOL scores, serum nerve functional related factors, hemorheology indexes, and vascular endothelial function indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.08% and 91.67%, respectively, and there was difference between two groups (P<0.05). After treatment, NIHSS scores and EuroQOL scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of NSE, Hcy, and S100β in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum nerve functional related factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, plasma viscosity, whole blood high shear viscosity, and whole blood low shear viscosity in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the hemorheology indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of ET-1 in two groups were significantly decreased, but the levels of NO in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the vascular endothelial function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Ginkgo Leaf Extract and Armillariella Mellea Powders Oral Solution combined with Alteplase for injection has clinical curative effect in treatment of acute cerebral infarction, can promote the recovery of nerve function, improve hemorheology and vascular endothelial function, and improve the quality of life of patients, which has a certain clinical application value.

R971