目的 探討丹紅注射液聯(lián)合阿替普酶治療不同分型急性腦梗死的臨床療效。方法 選取2013年4月-2015年3月榆林市第二醫(yī)院和西安交通大學(xué)第二附屬醫(yī)院的急性腦梗死患者72例，隨機(jī)分為對(duì)照組和治療組，每組各36例。對(duì)照組給予注射用阿替普酶，0.9 mg/kg，10%靜脈推注，90%靜脈滴注，1 h內(nèi)滴注完畢，最大劑量不超過(guò)90 mg。治療組在對(duì)照組基礎(chǔ)上靜脈滴注丹紅注射液，20 mL加入到生理鹽水250 mL，1次/d。兩組患者治療2周。觀察兩組的臨床療效，比較兩組溶栓前后多普勒超聲（TCD）參數(shù)、TCD血流分型、神經(jīng)功能缺損癥狀量表（NIHSS）評(píng)分、Rankin表（mRS）評(píng)分的變化。結(jié)果 治療后，對(duì)照組和治療組完全閉塞型總有效率分別為66.67%、83.33%，部分閉塞型總有效率分別為81.82%、90.00%，非閉塞型總有效率分別為94.74%、95.00%，兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。溶栓后，兩組完全閉塞、部分閉塞患者收縮期血流速度（Vs）、平均血流速（Vm）、舒張期血流速（Vd）均上升，搏動(dòng)指數(shù)（PI）下降，同組溶栓前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)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，兩組完全閉塞、部分閉塞比例下降，非閉塞型比例上升，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)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1、2周后，兩組完全閉塞、部分閉塞、非閉塞患者NIHSS評(píng)分均降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的降低程度明顯優(yōu)于同期對(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3個(gè)月，治療組部分閉塞和非閉塞患者mRS評(píng)分顯著下降，同類型治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組非閉塞患者mRS評(píng)分明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 丹紅注射液聯(lián)合阿替普酶治療不同分型急性腦梗死具有較好臨床療效，可改善患者腦功能，促進(jìn)閉塞血管再通，改善血流動(dòng)力學(xué)，有益于短期預(yù)后，安全性好，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of Danhong Injection combined with alteplase in treatment of different types of acute cerebral infarction. Methods Patients (72 cases) with acute cerebral infarction in Yulin Second Hospital and the Second Affiliated Hospital of Xi'an Jiaotong University from April 2013 to March 2015 were randomly divided into control and treatment groups, and each group had 36 cases. Patients in the control group were iv administered with Alteplase for injection, 0.9 mg/kg, 10% iv bolus injection, 90% iv drip, the infusion is completed within 1 h, and the maximum dose is not more than 90 mg. Patients in the treatment group were iv administered with Danhong Injection on the basis of the control group, 20 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and TCD parameters, TCD blood flow typing, NIHSS scores, and mRS scores in two groups were compared. Results After treatment, the clinical efficacies in the total, partial, and non-occlusion types of the control group were 66.67%, 81.82%, and 94.74%, respectively, and those of the treatment group were 83.33%, 90.00%, and 95.00%, respectively, and there was no difference between two groups. After thrombolysis, Vs, Vm, and Vd in the total and partial occlusion type of the control and treatment groups were increased, but PI in the total and partial occlusion type of the control and treatment groups were decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the proportion of the total and partial occlusion type of the control and treatment groups was decreased, but the proportion of the non-occlusion type of the control and treatment groups was increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After the first and second week treatment, the NIHSS scores of the total, partial, and non-occlusion type of the control and treatment groups were decrease, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After 3 months treatment, the mRS scores of the partial and non-occlusion type of the treatment group were significantly decreased, and the difference was statistically significant in the same type (P<0.05). And the mRS score of the non-occlusion type of the treatment group were significantly lower than that in the control group, with significant difference between two groups (P<0.05). Conclusion Danhong Injection combined with alteplase has clinical curative effect in treatment of different types of acute cerebral infarction, and can improve brain function, promote occluded vessels recanalization, improve hemodynamics, which is beneficial to short-term prognosis, with good safety, which has a certain clinical application value.