目的 探討注射用紅花黃色素聯(lián)合阿加曲班治療急性腦梗死的臨床療效。方法 選取2014年9月—2015年9月西安醫(yī)學(xué)院第二附屬醫(yī)院收治的急性腦梗死患者96例,依據(jù)不同治療方案分為治療組和對(duì)照組,每組各48例。所有患者均給予降低顱內(nèi)壓、營(yíng)養(yǎng)神經(jīng)、調(diào)節(jié)血脂等基礎(chǔ)治療。對(duì)照組在此基礎(chǔ)上給予阿加曲班注射液,第1~2天,阿加曲班注射液60 mg加入生理鹽水500 mL,24 h持續(xù)泵入;其后5 d,阿加曲班注射液10 mg加入生理鹽水100 mL,3 h持續(xù)泵入,2次/d,第8~14天,1次/d。治療組在對(duì)照組的基礎(chǔ)上滴注注射用紅花黃色素,100 mL/次,1次/d。兩組均連續(xù)治療2周。觀察兩組臨床療效,同時(shí)比較兩組神經(jīng)功能缺損量表(NIHSS)評(píng)分、Barthel指數(shù)、血液流變學(xué)指標(biāo)和血管內(nèi)皮功能及炎癥因子變化情況。結(jié)果 治療后,對(duì)照組和治療組總有效率分別為77.08%、91.67%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組血漿黏度、全血黏度、紅細(xì)胞壓積(HCT)以及紅細(xì)胞聚集指數(shù)(RF)均顯著降低,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療后治療組這些觀察指標(biāo)顯著低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組NIHSS評(píng)分均降低,Barthel指數(shù)均升高,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療2周后治療組這些觀察指標(biāo)顯著好于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組一氧化氮(NO)、內(nèi)皮素-1(ET-1)、白細(xì)胞介素-8(IL-8)和腫瘤壞死因子α(TNF-α)表達(dá)水平均較治療前明顯改善,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療2周后治療組這些觀察指標(biāo)顯著好于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 注射用紅花黃色素聯(lián)合阿加曲班治療急性腦梗死具有較好的臨床療效,能明顯改善患者的血液流變學(xué)指標(biāo)和血管內(nèi)皮功能,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate clinical efficacy of Safflower Yellow for injection combined with argatroban in treatment of acute cerebral infarction. Methods Patients (96 cases) with acute cerebral infarction in Second Affiliated Hospital of Xi'an Medical University from September 2014 to September 2015 were divided into control and treatment groups based on different treatment method, and each group had 48 cases. All patients were treated with conventional treatments including reducing intracranial pressure, trophic nerve, and regulating blood fat. Patients in control group were administered with Argatroban Injection on the basis of conventional treatment, 60 mg added into normal saline 500 mL and through 24 h continuous iv pump infusion in first and second day; the next five days they were treated with Argatroban Injection, 10 mg added into normal saline 100 mL and through 3 h continuous iv pump infusion twice daily, and 8th to 14th day once daily. The patients in the treatment group were iv administered with Safflower Yellow for injection on the basis of the control group, 100 mL/time, once daily. The patients in two groups were treated for two weeks. After treatment, the efficacy was evaluated, and the changes of NIHSS scores, Barthel indexes, vascular endothelial function, and inflammatory factors in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.08% and 91.67%, respectively, and there were differences between two groups (P< 0.05). After treatment, plasma viscosity, whole blood viscosity, hematocrits (HCT), and erythrocyte aggregation index (RF) in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). And the observational index in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). After treatment, NIHSS scores were significant decreased, Barthel indexes were significant increased, and the difference was statistically significant in the same group (P< 0.05). And after treatment for two weeks, the observational index in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). After treatment, nitric oxide (NO), endothelin-1 (ET-1), interleukin-8 (IL-8), and tumor necrosis factor α (TNF-α) were significantly improved, and the difference was statistically significant in the same group (P< 0.05). And after treatment for two weeks, the observational index in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). Conclusion Safflower yellow for injection combined with argatroban has clinical curative effect in treatment of acute cerebral infarction, and significantly improve hemorheology and vascular endothelial function, which has a certain clinical application value.