目的 探討苦碟子注射液聯(lián)合吡拉西坦治療急性腦梗死的臨床療效。方法 選取2021年7月—2022年7月在開封市人民醫(yī)院治療的114例急性腦梗死患者，隨機(jī)分為對(duì)照組（57例）和治療組（57例）。對(duì)照組患者靜脈滴注注射用吡拉西坦，4 g加入生理鹽水250 mL，1次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注苦碟子注射液，40 mL加入生理鹽水250 mL，1次/d。兩組患者連續(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）、腦卒中專門化生活質(zhì)量表（SS-QOL）和Barthel指數(shù)評(píng)分，梗死灶體積及脂蛋白相關(guān)磷脂酶A₂（Lp-PLA₂）、S100蛋白（S100β）、泛素羧基末端水解酶-L1（UCH-L1）、谷胱甘肽過氧化物酶（GSH-Px）、超氧化物歧化酶（SOD）和中性粒細(xì)胞/淋巴細(xì)胞比值（NLR）水平。結(jié)果 治療后，對(duì)照組臨床有效率為85.96%，治療組臨床有效率為96.49%，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)分較治療前明顯下降，而SS-QOL、Barthel指數(shù)評(píng)分明顯升高（P<0.05），且治療組NIHSS評(píng)分低于對(duì)照組，SS-QOL、Barthel指數(shù)評(píng)分高于對(duì)照組（P<0.05）。治療后，兩組NLR、Lp-PLA₂、S100β、UCH-L1水平較治療前均顯著下降，而SOD、GSH-Px水平較治療前顯著提高（P<0.05），且治療組NLR、Lp-PLA₂、S100β、UCH-L1、SOD、GSH-Px水平比對(duì)照組改善更明顯（P<0.05）。治療后，兩組患者梗死灶體積較治療前均顯著降低（P<0.05），且治療組梗死灶體積降低的更明顯（P<0.05）。結(jié)論 苦碟子注射液聯(lián)合吡拉西坦治療急性腦梗死具有良好的臨床療效，可促進(jìn)神經(jīng)功能恢復(fù)，提升日常生活能力和生活質(zhì)量，能抑制炎性反應(yīng)和氧化應(yīng)激反應(yīng)，減輕神經(jīng)細(xì)胞損傷。

Objective To explore the clinical efficacy of Kudiezi Injection combined with piracetam in treatment of acute cerebral infarction. Methods Patients (114 cases) with acute cerebral infarction in Kaifeng People's Hospital from July 2021 to July 2022 were randomly divided into control (57 cases) and treatment (57 cases) group. Patients in the control group were iv administered with Piracetam for injection, 4 g added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Kudiezi Injection on the basis of the control group, 40 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, and the scores of NIHSS, SS-QOL and Barthel, the infarct volume, the levels of NLR, Lp-PLA2, S100β, UCH-L1, SOD and GSH-Px in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was 85.96%, and which in the treatment group was 96.49%. and the difference between the two groups was statistically significant (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, while the scores of SS-QOL and Barthel index were significantly increased (P < 0.05), and the NIHSS score in the treatment group was lower than that of the control group, while the SS-QOL and Barthel index scores of the treatment group were higher than those of the control group (P < 0.05). After treatment, the levels of NLR, Lp-PLA2, S100β and UCH-L1 in two groups were significantly decreased, while the levels of SOD and GSH-Px were significantly increased in two groups (P < 0.05), and the improvement in the treatment group was more obvious than that in the control group (P < 0.05). After treatment, the infarctvolume in two groups was significantly lower than that before treatment (P < 0.05), and the infarct volume in the treatment group was decreased more significantly (P < 0.05). Conclusion Kudiezi Injection combined with piracetam has a good clinical effect in the treatment of acute cerebral infarction, which can promote the recovery of neurological function, improve the ability of daily life and quality of life, inhibit inflammatory reaction and oxidative stress reaction, and reduce nerve cell injury.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃（LHGJ20200843）