目的 探討丹參多酚酸治療急性腦梗死的臨床療效。方法 選取2013年4月-2015年4月延安市人民醫(yī)院收治的腦梗死患者67例，隨機分為對照組（32例）和治療組（35例）。對照組給予常規(guī)吸氧、抗血小板聚集、神經(jīng)營養(yǎng)藥物治療，根據(jù)病情需要給予降糖、調(diào)整血壓、抗感染等對癥處理。治療組在對照組基礎(chǔ)上靜脈滴注注射用丹參多酚酸鹽，200 mg加入氯化鈉溶液250 mL中，1次/d。兩組患者持續(xù)用藥14 d。觀察兩組的臨床療效，比較兩組氧化應(yīng)激、凝血指標、腦血流動力學(xué)、腦血流灌注指標、腦梗死體積、神經(jīng)功能缺損（NIHSS）評分及日常生活活動量表（Barthel指數(shù)）的情況。結(jié)果 治療后，對照組和治療組的總有效率分別為59.38%、82.86%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組檢測丙二醛（MDA）均明顯下降，超氧化物歧化酶（SOD）明顯上升，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組纖維蛋白原（FIB）、D-二聚體（D-D）均明顯下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標的下降程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組腦前動脈（ACA）、大腦中動脈（MCA）、大腦后動脈（PCA）均明顯上升，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標的升高程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組腦血流量相對值（rCBF）、腦血流容積相對值（rCBV）明顯上升，腦血流平均通過時間相對值（rMTT）、對比劑峰值時間相對值（rTTP）、梗死體積明顯下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組NIHSS評分明顯下降，Barthel指數(shù)明顯上升，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 丹參多酚酸治療急性腦梗死具有較好的臨床療效，可降低血液黏度，減輕機體氧化應(yīng)激反應(yīng)，改善腦血流動力學(xué)，減少腦梗死體積，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of salvianolate in treatment of acute cerebral infarction. Methods Patients (67 cases) with acute cerebral infarction in Yan'an People's Hospital from April 2013 to April 2015 were randomly divided into control group (32 cases) and treatment group (35 cases). Patients in the control group were given conventional oxygen inhalation, antiplatelet aggregation, and neurotrophic drug. And according to the needs of the disease, patients should be given symptomatic treatment including hypoglycemic, adjusting blood pressure, and anti-infection. Patients in the treatment group were iv administered with Salvianolate for injection on the basis of the control group, 200 mg added into normal saline 250 mL, once daily. After treatment, the clinical efficacies were evaluated, and oxidative stress, coagulation indexes, cerebral hemodynamics, cerebral blood flow perfusion index, cerebral infarction volume, NIHSS scores, and Barthel indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 59.38% and 82.86%, respectively, and there was difference between two groups (P<0.05). After treatment, MDA in two groups were significantly decreased, but SOD in two groups were significantly increased, significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, FIB and and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were D-D in two groups were significantly decreased, 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 treatment, ACA, MCA, and PCA in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, rCBF and rCBV in two groups were significantly increased, but rMTT and rTTP in two groups were significantly 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, NIHSS scores in two groups were significantly decreased, but Barthel indexes in two groups were significantly 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). Conclusion Salvianolate has clinical curative effect in treatment of acute cerebral infarction, and can decrease blood viscosity, reducing oxidative stress, improve cerebral hemodynamics, reduce cerebral infarction volume, which has a certain clinical application value.