目的 探究杏芎氯化鈉注射液聯(lián)合阿替普酶治療急性腦梗死臨床療效。方法 選取2018年4月—2020年10月河北工程大學(xué)附屬醫(yī)院收治的急性腦梗死患者165例作為研究對象，根據(jù)治療方法將患者分為對照組（82例）和觀察組（83例）。對照組給予注射用阿替普酶，0.9 mg/（kg·d），總量的10%采用靜脈推注給藥，其余90%給予靜脈滴注，60 min內(nèi)滴注完畢。觀察組在對照組基礎(chǔ)上靜脈滴注杏芎氯化鈉注射液100 mL，1次/d。兩組均連續(xù)治療2周。觀察兩組患者的臨床療效，同時比較兩組治療前后的美國國立衛(wèi)生院腦卒中量表（NIHSS）評分、腦血流灌注、血液流變學(xué)指標(biāo)、血清學(xué)指標(biāo)及藥物安全性。結(jié)果 治療后，觀察組總有效率為95.18%，顯著高于對照組的82.93%（P<0.05）。治療后，兩組NIHSS評分均較治療前降低（P<0.05），且觀察組NIHSS評分顯著低于對照組（P<0.05）。治療后，兩組腦血流量（CBF）、腦血容量（CBV）較治療前顯著升高，平均通過時間（MTT）、峰值時間（TTP）較治療前降低（P<0.05）；且觀察組腦血流灌注情況顯著優(yōu)于對照組（P<0.05）。治療后，兩組血漿黏度、纖維蛋白原、紅細(xì)胞壓積均較治療前降低（P<0.05），且治療后，觀察組血液流變學(xué)指標(biāo)顯著優(yōu)于對照組（P<0.05）。治療后，兩組血清和肽素（CPP）、CXC趨化因子配體12（CXCL12）、血管細(xì)胞間黏附分子-1（VCAM-1）、細(xì)胞間黏附分子-1（ICAM-1）水平均較治療前降低（P<0.05），且觀察組CPP、CXCL12、VCAM-1、ICAM-1水平低于對照組（P<0.05）。兩組安全性比較差異無統(tǒng)計學(xué)意義。結(jié)論 杏芎氯化鈉注射液聯(lián)合阿替普酶治療急性腦梗死效果較好，可減輕神經(jīng)功能缺損，降低機(jī)體血液黏度，增加缺血區(qū)腦血流灌注量，有較好的臨床應(yīng)用價值。

Objective To explore the clinical efficacy of Xingxiong Sodium Chloride Injection combined with alteplase in treatment of acute cerebral infarction. Methods A total of 165 patients with acute cerebral infarction admitted to the Affiliated Hospital of Hebei University of Engineering from April 2018 to October 2020 were selected as the research subjects, and the patients were divided into control group (82 cases) and observation group (83 cases) by treatment method. Patients in the control group were given Alteplase for injection, 0.9 mg/(kg·d), 10% of the total amount was given intravenously, and the rest 90% was given intravenously, and the infusion was completed within 60 min. Patients in the observation group were iv administered with Xingxiong Sodium Chloride Injection on th basis of control group, once daily. Both groups were treated continuously for 2 weeks. Clinical efficacy of two groups was observed, and NIHSS scores, cerebral blood perfusion, hemorheology indexes, serological indexes, and drug safety before and after treatment were compared between two groups. Results After treatment, the total effective rate of observation group was 95.18%, which was significantly higher than 82.93% of control group (P < 0.05). After treatment, NIHSS scores in two groups were lower than those before treatment (P < 0.05), and NIHSS scores in observation group were significantly lower than those in control group (P < 0.05). After treatment, the CBF and CBV in two groups were significantly increased, while the MTT and TTP were decreased (P < 0.05). The cerebral blood perfusion in the observation group was significantly better than that in the control group (P < 0.05). After treatment, plasma viscosity, fibrinogen, and erythrocyte backlog in two groups decreased compared with before treatment (P < 0.05), after treatment, hemorheological indexes in observation group were significantly lower than those in control group (P < 0.05). After treatment, the levels of CPP, CXCL12, VCAM-1, and ICAM-1 in serum of two groups were decreased compared with before treatment (P < 0.05), and the levels of CPP, CXCL12, VCAM-1, and ICAM-1 in observation group were lower than those in control group (P < 0.05). There was no significant difference in safety between two groups. Conclusion Xingxiong Sodium Chloride Injection combined with alteplase in treatment of acute cerebral infarction has a good effect, can reduce the neurological function deficit, reduce the body's inflammatory response and blood viscosity, increase the cerebral blood perfusion in the ischemic area, has a good clinical value.

R971

河北省科技計劃項目（17277714D）；邯鄲市科學(xué)技術(shù)研究與發(fā)展計劃項目（19422083028ZC）