杏芎氯化钠注射液联合阿替普酶治疗急性脑梗死的临床研究

目的 探究杏芎氯化钠注射液联合阿替普酶治疗急性脑梗死临床疗效。方法 选取2018年4月—2020年10月河北工程大学附属医院收治的急性脑梗死患者165例作为研究对象，根据治疗方法将患者分为对照组（82例）和观察组（83例）。对照组给予注射用阿替普酶，0.9 mg/（kg·d），总量的10%采用静脉推注给药，其余90%给予静脉滴注，60 min内滴注完毕。观察组在对照组基础上静脉滴注杏芎氯化钠注射液100 mL，1次/d。两组均连续治疗2周。观察两组患者的临床疗效，同时比较两组治疗前后的美国国立卫生院脑卒中量表（NIHSS）评分、脑血流灌注、血液流变学指标、血清学指标及药物安全性。结果 治疗后，观察组总有效率为95.18%，显著高于对照组的82.93%（P<0.05）。治疗后，两组NIHSS评分均较治疗前降低（P<0.05），且观察组NIHSS评分显著低于对照组（P<0.05）。治疗后，两组脑血流量（CBF）、脑血容量（CBV）较治疗前显著升高，平均通过时间（MTT）、峰值时间（TTP）较治疗前降低（P<0.05）；且观察组脑血流灌注情况显著优于对照组（P<0.05）。治疗后，两组血浆黏度、纤维蛋白原、红细胞压积均较治疗前降低（P<0.05），且治疗后，观察组血液流变学指标显著优于对照组（P<0.05）。治疗后，两组血清和肽素（CPP）、CXC趋化因子配体12（CXCL12）、血管细胞间黏附分子-1（VCAM-1）、细胞间黏附分子-1（ICAM-1）水平均较治疗前降低（P<0.05），且观察组CPP、CXCL12、VCAM-1、ICAM-1水平低于对照组（P<0.05）。两组安全性比较差异无统计学意义。结论 杏芎氯化钠注射液联合阿替普酶治疗急性脑梗死效果较好，可减轻神经功能缺损，降低机体血液黏度，增加缺血区脑血流灌注量，有较好的临床应用价值。

Clinical study of Xingxiong Sodium Chloride Injection combined with alteplase in treatment of acute cerebral infarction

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.