注射用丹参多酚酸联合阿替普酶治疗急性脑梗死的疗效观察和预后评价

目的 观察注射用丹参多酚酸联合阿替普酶治疗急性脑梗死的疗效及预后。方法 选取安阳市中医院于2019年1月-2020年1月期间收治的急性脑梗死溶栓患者85例为研究对象。采用随机数字表法将患者分为对照组（40例）和观察组（45例）。对照组使用注射用阿替普酶进行静脉溶栓治疗，最大剂量90 mg/d，首次注射1 min内先将阿替普酶剂量的10%静脉推注，剩余剂量在60 min内使用微量泵持续泵入。观察组在溶栓完毕后立即静脉滴注注射用丹参多酚酸，130 mg/次，1次/d，共治疗14 d。对比两组患者治疗后的神经功能、预后及安全性。结果 治疗后，对照组和观察组有效率分别为77.5%和93.3%，两组比较差异有统计学意义（P<0.05）。治疗后，对照组和观察组的美国国立卫生研究院卒中量表评分（NIHSS）中位数为4.5（1，9.25）和3（1，4），两组比较差异具有统计学意义（P<0.05）。治疗90 d内，两组不良事件发生率分别为7.5%和6.7%，两组间比较差异无统计学意义；死亡率比较差异无统计学意义。治疗90 d后，两组分别有20例（50%）、33例（73.3%）患者预后良好，两组治疗后比较差异具有统计学意义（P<0.05）。结论 急性脑梗死超急性期溶栓后加用注射用丹参多酚酸，可改善患者的神经功能，且不增加出血及死亡风险。

Efficacy and prognosis of Salvianolic Acids for Injection combined with alteplase in treatment of acute cerebral infarction

Objective To observe the efficacy and prognosis of Salvianolic Acids for Injection combined with alteplase in treatment of acute cerebral infarction. Methods A total of 85 patients with acute cerebral infarction admitted to Anyang Hospital of Traditional Chinese Medicine from January 2019 to January 2020 were selected as the study subjects. Patients were divided into control group (40 cases) and observation group (45 cases) by random number table method. Patients in the control group were treated with intravenous thrombolysis with Alteplase for Injection at a maximum dose of 90 mg/d, 10% of alteplase was injected intravenously within 1 min of the first injection, and the remaining dose of alteplase was continuously pumped with a micro pump within 60 min. Patients in the control group were intravenous infusion of Salvianolic Acids for Injection, 130 mg/d once daily administered immediately after thrombolysis for 14 days. After treatment, the neurological function, prognosis and safety of two groups were compared. Results After treatment, the effective rates of the control group and observation group were 77.5% and 93.3%, respectively, with statistically significant differences between the two groups (P<0.05). After treatment, the median NIHSS score in two groups was 4.5 (1, 9.25) and 3 (1, 4), respectively, and the difference between two groups was statistically significant (P<0.05). Within 90 days of treatment, the incidence of adverse events in two groups was 7.5% and 6.7%, respectively, with no statistically significant difference between two groups. And there was no statistically significant difference in mortality. After 90 days of treatment, 20 patients (50%) and 33 patients (73.3%) in two groups respectively had a good prognosis, and the difference between two groups after treatment was statistically significant (P<0.05). Conclusion After hyperacute thrombolysis of acute cerebral infarction, the usage of Salvianolic Acids for Injection can improved neurological function, without increasing the risk of bleeding or death.