目的 探討注射用丹參多酚酸對(duì)急性腦梗死合并糖尿病患者的臨床療效、認(rèn)知功能、抗氧化能力以及血管內(nèi)皮功能的影響。方法 選取2017年4月-2019年3月河南大學(xué)第一附屬醫(yī)院診治的急性腦梗死合并糖尿病患者92例作為研究對(duì)象，按隨機(jī)數(shù)字表法將患者隨機(jī)分為對(duì)照組和觀察組，每組各46例。對(duì)照組患者均根據(jù)具體病情采取對(duì)癥內(nèi)科綜合治療方案，而觀察組患者在此基礎(chǔ)上靜脈滴注注射用丹參多酚酸，0.13 g加入到0.9%氯化鈉注射液250 mL，1次/d。兩組均治療2周后評(píng)價(jià)療效。觀察兩組患者的臨床療效，同時(shí)比較兩組患者治療前后的認(rèn)知功能、抗氧化指標(biāo)以及血管內(nèi)皮功能指標(biāo)。結(jié)果 治療后，對(duì)照組總有效率為80.4%，顯著低于觀察組的91.3%，兩組比較存在顯著性差異（P<0.05）。治療后，兩組患者的簡(jiǎn)易精神狀態(tài)量表（MMSE）和蒙特利爾認(rèn)知評(píng)估量表法（MoCA）評(píng)分均明顯升高，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05），且觀察組MMSE和MOCA評(píng)分明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的超氧化物歧化酶（SOD）水平明顯升高，丙二醛（MDA）水平明顯降低，同組治療前后比較差異存在統(tǒng)計(jì)學(xué)意義（P<0.05），且觀察組SOD和MDA水平顯著優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的內(nèi)皮素-1（ET-1）水平明顯降低，血管內(nèi)皮生長(zhǎng)因子（VEGF）、一氧化氮（NO）水平明顯升高，同組治療前后間差異具有統(tǒng)計(jì)學(xué)意義（P<0.05），且觀察組血管內(nèi)皮功能指標(biāo)水平顯著優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 在基本對(duì)癥治療方案的前提下使用注射用丹參多酚酸治療急性腦梗死合并糖尿病的患者，不僅能夠顯著改善患者的臨床癥狀與體征，進(jìn)一步提高患者的認(rèn)知功能，而且能夠?qū)C(jī)體的抗氧化、血管內(nèi)皮功能產(chǎn)生明確的改善效果，值得臨床上進(jìn)一步研究使用。

Objective To investigate the effects of Salvianolic Acids for Injection on the clinical efficacy, cognitive function, antioxidant capacity and vascular endothelial function of patients with acute cerebral infarction complicated with diabetes. Methods A total of 92 patients with acute cerebral infarction complicated with diabetes who were diagnosed and treated in the The First Affiliated Hospital of Henan University from April 2017 to March 2019 were selected as the research objects. According to the random number table method, the patients were randomly divided into the control group and the observation group, with 46 patients in each group. Patients in the control group were given comprehensive symptomatic medical treatment according to their specific conditions, while patients in the observation group were iv administered with Salvianolic Acids for Injection and 0.13 g added into 0.9% sodium chloride injection 250 mL, once daily. Both groups were evaluated after 2 weeks of treatment. The clinical efficacy in two groups of patients was observed, and the cognitive function, antioxidant index and vascular endothelial function index before and after treatment were compared between two groups. Results After treatment, the total effective rate in the control group was 80.4%, which was significantly lower than 91.3% of the observation group, with significant difference between the two groups (P<0.05). After treatment, MMSE and MOCA scores of both groups were significantly increased, and the difference in the same group before and after treatment was statistically significant (P<0.05). After treatment, MMSE and MOCA scores of the observation group were significantly higher than those of the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the level of SOD was significantly increased, but MDA was significantly decreased, and the difference in the same group before and after treatment was statistically significant (P<0.05), and the levels of SOD and MDA in the observation group were significantly better than those in the control group, and the difference between two groups was also statistically significant (P<0.05). After treatment, ET-1 level was significantly decreased, but the levels of VEGF and NO in two groups were significantly increased, and the differences in the same group before and after treatment were statistically significant (P<0.05). Moreover, the vascular endothelial function index levels in the observation group was significantly better than that in the control group, and the differences between the two groups were statistically significant (P<0.05). Conclusion Under the premise of the basic symptomatic treatment plan, Salvianolic Acids for Injection in treatment of patients with acute cerebral infarction complicated with diabetes can not only significantly improve the clinical symptoms and signs of the patients, further improve the patients' cognitive function, but also produce a definite improvement effect on the body's antioxidant and vascular endothelial function, which is worthy of further clinical study.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201702133）