目的 探討依達拉奉右莰醇注射用濃溶液聯(lián)合己酮可可堿注射液治療急性腦梗死的臨床療效。方法 2021年4月1日—2022年4月30日在溧陽人民醫(yī)院接受治療的150例急性腦梗死患者，按照使用藥物的差別分為對照組和治療組，每組各75例。對照組靜脈泵入己酮可可堿注射液，將0.2 g己酮可可堿注射液同0.9%氯化鈉注射液250 mL配伍，1次/d。治療組在對照組基礎(chǔ)上靜脈滴注依達拉奉右莰醇注射用濃溶液，15 mL同0.9%氯化鈉注射液100 mL配伍，2次/d。兩組患者均經(jīng)14 d治療。觀察兩組的臨床療效，比較兩組治療前后美國國立衛(wèi)生院卒中量表（NIHSS）評分、改良Rankin量表（MRS）評分、大腦中動脈（MCA）供血區(qū)缺血改變量表（DWI-ASPECTS）評分、功能獨立性評測量表（FIM）評分、日常生活活動能力量表（ADL）評分、血清細胞因子、血液流變學指標的變化情況。結(jié)果 治療后，治療組總有效率為96.00%，顯著高于對照組的81.33%，差異具有統(tǒng)計學意義（P＜0.05）。治療后，兩組NIHSS評分、MRS評分均較治療前顯著降低，而DWI-ASPECTS評分、FIM評分、ADL評分均較治療前顯著升高（P＜0.05）；并以治療組改善更為明顯（P＜0.05）。治療后，兩組血清超敏C反應蛋白（hc-CRP）、尿酸（UA）、白細胞介素-6（IL-6）、半胱氨酸（Hcy）、腫瘤壞死因子-α（TNF-α）水平均較治療前顯著降低，且治療組改善更明顯（P＜0.05）。治療后，兩組纖維蛋白原（FIB）、紅細胞壓積（HCT）均較治療前顯著降低，而活化部分凝血活酶時間（APTT）顯著延長（P＜0.05），且治療后，治療組血液流變學指標改善更明顯（P＜0.05）。結(jié)論 依達拉奉右莰醇注射用濃溶液聯(lián)合己酮可可堿注射液治療急性腦梗死具有較好的臨床療效，可有效促進患者神經(jīng)功能恢復，提高患者日常生活活動能力，改善血清細胞因子和血液流變學指標，有著良好的臨床應用價值。

Objective To investigate the clinical efficacy of Edaravone and Dexborneol Concentrated Solution for injection combined with pentoxifylline in treatment of acute cerebral infarction. Methods A total of 150 patients with acute cerebral infarction who received treatment in Liyang People’s Hospital from April 1, 2021 to April 30, 2022 were divided into control group and treatment group according to the difference of drugs used, with 75 cases in each group. Patients in the control group were intravenously pumped with Pentoxifylline Injection, 0.2 g Pentoxifylline Injection was mixed with 0.9% sodium chloride injection 250 mL, once daily. Patients in the treatment group were iv administered with Edaravone and Dexborneol Concentrated Solution for injection on the basis of control group, 15 mL in combination with 0.9% Sodium chloride injection 100 mL, twice daily. Both groups were treated for 14 d. The clinical efficacy of the two groups was observed, and changes of NIHSS score, MRS score, DWI-ASPECTS score, FIM score, ADL score, serum cytokines, and hemorheological indexes in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.00%, which was significantly higher than that of the control group (81.33%), and the difference was statistically significant (P < 0.05). After treatment, NIHSS score and MRS Score were significantly decreased compared with before treatment, while DWI-ASPECTS score, FIM score and ADL score were significantly increased compared with before treatment (P < 0.05). The improvement was more obvious in the treatment group (P < 0.05). After treatment, serum levels of hypersensitive C-reactive protein (hc-CRP), uric acid (UA), interleukin-6 (IL-6), cysteine (Hcy) and tumor necrosis factor-α (TNF-α) in 2 groups were significantly decreased compared with before treatment, and the improvement was more obvious in treatment group (P < 0.05). After treatment, fibrinogen (FIB) and hematopoietic volume (HCT) were significantly decreased in both groups, while activated partial thrombin time (APTT) was significantly prolonged (P < 0.05). After treatment, hemorheology indexes were improved more significantly in the treatment group (P < 0.05). Conclusion Edaravone and Dexborneol Concentrated Solution for injection combined with pentoxifylline has good clinical effect in treatment of acute cerebral infarction, and can effectively promote the recovery of neurological function, improve patients’ ability of daily living activities, improve serum cytokines and hemorheology indexes, which has good clinical application value.

R971

常州市科技計劃項目（20200736）