目的 觀察注射用丹參多酚酸治療急性脈絡(luò)膜前動脈梗死的短期、長期療效及安全性。方法 回顧性選取濮陽市安陽地區(qū)醫(yī)院于2018年8月—2020年12月收治的102例急性脈絡(luò)膜前動脈梗死患者為研究對象，隨機(jī)分為對照組（n=50）和觀察組（n=52）。兩組患者中符合溶栓適應(yīng)癥，排除禁忌癥，且經(jīng)家屬同意的，于發(fā)病4.5 h內(nèi)給予溶栓治療。對照組患者均給予常規(guī)抗血小板聚集、降脂穩(wěn)定斑塊、控制血壓血糖等治療措施；觀察組在對照組常規(guī)治療的基礎(chǔ)上，住院當(dāng)天給予注射用丹參多酚酸0.13 g，溶于0.9%氯化鈉注射液250 mL中靜脈滴注，1次/d，連用14 d。比較兩組患者入院時、神經(jīng)功能缺損最重時、治療14 d后美國國立衛(wèi)生研究院卒中量表（NIHSS）評分，及治療3個月后改良Rankin量表（mRS）評分。隨訪治療3個月后兩組患者的全因死亡率及出血發(fā)生率以及不良反應(yīng)發(fā)生情況。結(jié)果 兩組患者在治療前，一般資料、危險因素及NIHSS評分無統(tǒng)計學(xué)差異（P>0.05）。治療過程中最重時的NIHSS評分，觀察組較對照組低，但差異無統(tǒng)計學(xué)意義（P>0.05），治療14 d后，觀察組NIHSS評分顯著低于對照組（P<0.05），3個月預(yù)后良好率（mRS評分≤2）顯著高于對照組（P<0.05）。治療3個月后，兩組全因死亡率及出血發(fā)生率相比均無統(tǒng)計學(xué)意義。兩組不良反應(yīng)總發(fā)生率無統(tǒng)計學(xué)差異。結(jié)論 常規(guī)治療聯(lián)合應(yīng)用注射用丹參多酚酸可以改善急性脈絡(luò)膜前動脈短期及長期預(yù)后，且不增加不良反應(yīng)，值得臨床應(yīng)用。

Objective To observe the short-term and long-term efficacy and safety of Salvianolic Acids for Injection in treatment of acute anterior choroidal artery infarction. Methods Total 102 patients with acute anterior choroidal artery infarction treated in Anyang District Hospital of Puyang City from August 2018 to December 2020 were randomly divided into control group (n=50) and observation group (n=52). The patients in two groups who met the thrombolytic indications, excluded the contraindications, and with the consent of their families, were given thrombolytic treatment within 4.5 hours of onset. Patients in the control group were given routine treatment measures such as anti platelet aggregation, reducing lipid and stabilizing plaque, controlling blood pressure and blood glucose. On the basis of routine treatment in the control group, patients in the observation group were given 0.13 g Salvianolic Acids for Injection and 250 mL of 0.9% sodium chloride injection on the day of hospitalization, once a day for 14 days. The scores of National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) after three months were compared between two groups. After three months of follow-up treatment, the all-cause mortality, bleeding rate and adverse reactions of two groups. Results There was no significant difference in general information, risk factors and NIHSS score between two groups before treatment (P>0.05). The NIHSS score of the observation group was lower than that of the control group, but the difference was not statistically significant (P>0.05). After 14 days of treatment, the NIHSS score of the observation group was significantly lower than that of the control group (P<0.05), and the good prognosis rate at three months (mRS score ≤ 2) was significantly higher than that of the control group (P<0.05). After three months of treatment, there was no significant difference in all-cause mortality and bleeding between two groups. There was no significant difference in the total incidence of adverse reactions between two groups. Conclusion Routine treatment combined with Salvianolic Acids for Injection can improve the short-term and long-term prognosis of acute anterior choroidal artery without increasing adverse reactions, which is worthy of clinical application.

R971

濮陽市科技攻關(guān)項目（1805069）