目的 探討復方曲肽注射液聯(lián)合注射用降纖酶治療急性腦梗死的臨床療效。方法 選取2017年5月-2019年5月在鄭州人民醫(yī)院治療的104例急性腦梗死患者，根據(jù)用藥差別分為對照組（52例）和治療組（52例）。對照組靜脈滴注注射用降纖酶，10單位加入生理鹽水250 mL，1次/d；治療組在對照組基礎上靜脈滴注復方曲肽注射液，10 mL加入生理鹽水250 mL，1次/d。兩組患者均經(jīng)2周治療。觀察兩組患者臨床療效，同時比較治療前后兩組患者ESRS、NIHSS、AD和mRS評分，血清和肽素（CPP）、血紅素氧合酶1（HO1）、可溶性腫瘤壞死因子相關凋亡誘導配體（sTRAIL）、新蝶呤（Npt）、CXC趨化因子配體12（CXCL12）和血小板激活因子（PAF）水平，紅細胞壓積（HCT）、全血黏度（WBV）、纖維蛋白原（FIB）和血漿黏度（PV）水平，及相對平均血流量（Q_mean）、平均血流速度（V_mean）、動態(tài)阻力（DR）、特性阻抗（ZCV）和腦血管周圍阻力（R）水平。結果 治療后，對照組臨床有效率為80.77%，顯著低于治療組的96.15%，兩組比較差異有統(tǒng)計學意義（P<0.05）。經(jīng)治療，兩組患者ESRS評分、NIHSS評分、mRS評分均明顯降低（P<0.05），而ADL評分明顯升高（P<0.05），且治療組患者這些評分明顯好于對照組（P<0.05）。經(jīng)治療，兩組患者CPP、HO1、sTRAIL、Npt、CXCL12、PAF、HCT、WBV、FIB和PV水平明顯降低（P<0.05），且治療組患者明顯低于對照組（P<0.05）。經(jīng)治療，兩組患者Q_mean和V_mean顯著降升高（P<0.05），DR、ZCV和R顯著降低（P<0.05），且治療組患者腦血流動力學明顯好于對照組（P<0.05）。結論 復方曲肽注射液聯(lián)合注射用降纖酶治療急性腦梗死有利于促進患者腦神經(jīng)功能恢復，提高患者生活質量、日?；顒幽芰徒档湍X血管事件發(fā)生風險。

Objective To investigate the clinical efficacy of Compound Troxerutin and Poreine Cerebroside Injection combined with Defibrase for injection in treatment of acute cerebral infarction. Methods Patients (104 cases) with acute cerebral infarction in Zhengzhou People's Hospital from May 2017 to May 2019 were divided into control (52 cases) and treatment (52 cases) groups based on different treatments. Patients in the control group were iv administered with Defibrase for injection, 10 unit added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Compound Troxerutin and Poreine Cerebroside Injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the ESRS scores, NIHSS scores, ADL scores, mRS scores, the serum level of CPP, HO1, sTRAIL, Npt, CXCL12 and PAF, HCT, WBV, FIB, PV, Q_mean, V_mean, DR, ZCV, and R levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.77%, which was significantly lower than 96.15% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the ESRS, NIHSS, and mRS scores in two groups were significantly decreased, but the ADL scores were significantly increased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the level of CPP, HO1, sTRAIL, Npt, CXCL12, PAF, HCT, WBV, FIB, PV in two groups was significantly decreased (P < 0.05), and which in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the Q_mean and V_mean in two groups were significantly increased, but the DR, ZCV and R were significantly decreased (P < 0.05), and the cerebral hemodynamic indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Compound Troxerutin and Poreine Cerebroside Injection combined with Defibrase for injection in treatment of acute cerebral infarction is conducive to promoting the recovery of nerve function, improving the quality of life, daily activity ability and reducing the risk of cerebrovascular events.

R971