目的 探究注射用丹參多酚酸對急性缺血性腦卒中的療效及對患者氧化應(yīng)激指標(biāo)和血流動力學(xué)指標(biāo)的影響。方法 回顧性選取2018年1月—2020年1月新里程安鋼總醫(yī)院收治的急性缺血性腦卒中患者120例為研究對象，將患者隨機分為對照組（n=60）和觀察組（n=60）。對照組患者采用常規(guī)治療方式，主要包括清除自由基、抗血小板聚集以及改善血液循環(huán)等。觀察組患者在對照組治療的基礎(chǔ)上加用注射用丹參多酚酸0.13 g溶于0.9%氯化鈉注射液250 mL中靜脈滴注，1次/d，治療療程14 d。通過美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、改良Rankin量表（mRS）評分評價兩組患者治療前后的神經(jīng)系統(tǒng)缺損程度，通過丙二醛（MDA）及超氧化物歧化酶（SOD）的測定評價兩組患者治療前后的氧化應(yīng)激水平，通過經(jīng)顱多普勒超聲（TCD）監(jiān)測大腦前動脈（ACA）、大腦中動脈（MCA）、大腦后動脈（PCA）血流速度評價兩組患者治療前后的血流動力學(xué)變化；對兩組患者出現(xiàn)的皮下血腫、顱內(nèi)出血以及肝腎功能異常等不良反應(yīng)進(jìn)行統(tǒng)計分析。結(jié)果 治療后觀察組的總有效率83.33%，顯著高于對照組的56.67%（P<0.05），治療后兩組患者的NIHSS、mRS評分均較治療前顯著下降（P<0.05）；且觀察組患者降低的更為顯著（P<0.05）。與治療前相比，兩組患者的MDA水平均顯著下降（P<0.05），SOD水平均顯著上升（P<0.05），且觀察組的改變幅度更為顯著（P<0.05）。與治療前相比，兩組患者的ACA、MCA及PCA血流速度均顯著升高（P<0.05），且觀察組患者的升高更為顯著（P<0.05）。治療后，與對照組相比，觀察組患者的不良反應(yīng)發(fā)生率較低（P<0.05）。結(jié)論 注射用丹參多酚酸能夠顯著改善急性缺血性腦卒中患者的神經(jīng)系統(tǒng)缺損癥狀，改善預(yù)后，且安全性好，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the efficacy of Salvianolic Acids for Injection on acute ischemic stroke and its effects on oxidative stress and hemodynamics. Methods Total 120 patients with acute ischemic stroke treated in New Milestone Angang General Hospital from January 2018 to January 2020 were selected retrospectively. The patients were randomly divided into control group (n=60) and observation group (n=60). The patients in the control group were treated with routine treatment, mainly including scavenging free radicals, anti platelet aggregation and improving blood circulation. On the basis of the treatment of the control group, the patients in the observation group were treated with 0.13 g Salvianolic Acids for Injection and 250 mL of 0.9% sodium chloride injection by intravenous drip, once a day, for 14 days. The neurological deficit of the two groups was evaluated by the National Institutes of Health Stroke Scale (NIHSS) score and the modified Rankin Scale (mRS) score before and after treatment, the oxidative stress levels of the two groups were evaluated by the determination of malondialdehyde (MDA) and superoxide dismutase (SOD). The blood flow velocities of anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) were monitored by transcranial Doppler (TCD) before and after treatment. The adverse reactions such as subcutaneous hematoma, intracranial hemorrhage and abnormal liver and kidney function in two groups were statistically analyzed.Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the NIHSS and mRS scores of two groups were significantly lower than those before treatment (P<0.05), and the decrease in the observation group was more significant (P<0.05). Compared with before treatment, the level of MDA decreased significantly (P<0.05), the level of SOD increased significantly (P<0.05), and the change range of the observation group was more significant (P<0.05). Compared with before treatment, the blood flow velocities of ACA, MCA and PCA in two groups increased significantly (P<0.05), and the increase in the observation group was more significant (P<0.05). After treatment, the incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05). Conclusion Salvianolic Acids for Injection can significantly improve the symptoms of nervous system defects and prognosis in patients with acute ischemic stroke, and has good safety. It has a certain value of clinical application.

R971