目的 觀察胞二磷膽堿聯(lián)合阿替普酶治療急性腦梗死的臨床療效。方法 選取解放軍第三一三醫(yī)院2013年1月—2016年12月收治的110例急性腦梗死患者為研究對(duì)象，隨機(jī)分為對(duì)照組和治療組，每組各55例。對(duì)照組患者靜脈泵入注射用阿替普酶，0.9 mg/kg，最大劑量為90 mg，1 min內(nèi)靜脈推注10%，然后60 min內(nèi)勻速靜脈泵入余下劑量。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注胞二磷膽堿注射液，0.75 g加入250 mL生理鹽水，持續(xù)時(shí)間>40 min，1次/d。兩組患者均連續(xù)治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）和Barthel指數(shù)評(píng)定量表（BI）評(píng)分。結(jié)果 治療后，對(duì)照組和治療組臨床總有效率分別為74.55%、90.91%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療7、14 d后，兩組患者的NIHSS評(píng)分較治療前明顯降低，BI評(píng)分明顯升高，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組NIHSS、BI評(píng)分明顯優(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）。結(jié)論 胞二磷膽堿聯(lián)合阿替普酶治療急性腦梗死療效顯著，可明顯改善患者的神經(jīng)功能和生存質(zhì)量，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical curative effect of citicoline combined with alteplase in treatment of acute cerebral infarction. Methods Patients (110 cases) with acute cerebral infarction in No. 313 Hospital of PLA from January 2013 to December 2016 were randomly divided into control and treatment groups, and each group had 55 cases. Patients in the control group were intravenous pumped with Alteplase for injection, 0.9 mg/kg, and the maximum dose was 90 mg. 10% of the dose was injected in 1 min, and then the other dose was intravenous pumped in 60 min with a constant speed. Patients in the treatment group were iv administered with Citicoline Injection, 0.75 g added into normal saline 250 mL, and duration time was more than 40 min, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the NIHSS and BI scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 74.55% and 90.91%, respectively, and there was difference between two groups (P < 0.05). After treatment for 7 and 14 d, the NIHSS scores in two groups were significantly decreased, but the BI scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the NIHSS and BI scores in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Citicoline combined with alteplase has good effect in treatment of acute cerebral infarction, and can improve the nerve function and quality of life, which has a certain clinical application value.