目的 探討利腦心片聯(lián)合胞磷膽堿治療急性腦梗死的臨床療效。方法 選取2018年1月-2022年1月北京市大興區(qū)中西醫(yī)結(jié)合醫(yī)院急診內(nèi)科收治的200例急性腦梗死患者，按照隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各100例。對(duì)照組患者靜脈滴注胞磷膽堿鈉注射液，0.5 g/次，加入5%葡萄糖注射液200 mL中滴注，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服利腦心片，3片/次，3次/d。兩組均用藥14 d。觀察兩組的臨床療效，比較兩組癥狀緩解時(shí)間，比較兩組治療前后社會(huì)活動(dòng)功能量表（FAQ）評(píng)分、美國(guó)國(guó)立衛(wèi)生院腦卒中量表（NIHSS）評(píng)分、白細(xì)胞介素-17（IL-17）、缺氧誘導(dǎo)因子-1α（HIF-1α）、血清基質(zhì)金屬蛋白酶-9（MMP-9）、腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）水平的變化情況。結(jié)果 治療后，治療組患者總有效率是98.0%，顯著高于對(duì)照組的89.0%（P<0.05）。治療后，治療組頭暈、肢體活動(dòng)障礙、肢體感覺(jué)異常、記憶力下降等癥狀改善時(shí)間均顯著短于對(duì)照組（P<0.05）。治療后，兩組FAQ評(píng)分、NIHSS評(píng)分均較治療前顯著降低（P<0.05）；且治療后，治療組FAQ評(píng)分、NIHSS評(píng)分顯著低于對(duì)照組（P<0.05）。治療后，兩組IL-17、HIF-1α、MMP-9水平均較治療前顯著降低，BDNF水平顯著升高（P<0.05）；治療后治療組IL-17、HIF-1α、MMP-9水平低于對(duì)照組，而B(niǎo)DNF水平高于對(duì)照組（P<0.05）。結(jié)論 利腦心片聯(lián)合胞磷膽堿治療急性腦梗死療效確切，可有效改善患者日常活動(dòng)能力，并能降低腦神經(jīng)損傷程度，減弱局部炎性反應(yīng)，值得臨床借鑒應(yīng)用。

Objective To explore the clinical study of Linaoxin Tablets combined with citicoline sodium in treatment of acute cerebral infarction. Methods A total of 200 patients with acute cerebral infarction admitted to Department of Emergency of Beijing Daxing District Hospital of Integrated Traditional and Western Medicine from January 2018 to January 2022 were selected and divided intocontrol group and treatment group according to random number table method, with 100 patients in each group. Patients in the control group were iv administered with Citicoline Sodium Injection, 0.5g/time, added into 5% glucose injection 200 mL, once daily. Patients in the treatment group were po administered with Linaoxin Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the symptom relief time of the two groups was compared. The Social Activity Function Scale (FAQ) scores, National Institutes of Health Stroke Scale (NIHSS) scores, interleukin-17 (IL-17), hypoxia-inducing-factor-1α (HIF-1α), serum matrix metalloproteinase-9 (MMP-9) and brain-derived neurotrophic factor (BDNF) were compared between the two groups before and after treatment. Results After treatment, the total effective rate in the treatment group was 98.0%, which was significantly higher than 89.0% in the control group (P < 0.05). After treatment, the improvement time of dizziness, limb movement disorder, limb paresthesia, memory decline and other symptoms in the treatment group was significantly shorter than that in the control group (P< 0.05). After treatment, FAQ scores and NIHSS scores in both groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, FAQ scores and NIHSS scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of IL-17, HIF-1α and MMP-9 in two groups were significantly decreased compared with before treatment, and the level of BDNF was significantly increased (P < 0.05). After treatment, the levels of IL-17, HIF-1α and MMP-9 in the treatment group were lower than those in the control group, but the levels of BDNF were higher than those in the control group (P < 0.05). Conclusion Linaoxin Tablets combined with citicoline sodium has a definite therapeutic effect in treatment of acute cerebral infarction, and can effectively improve daily activity ability, reduce the degree of cranial nerve injury, and weaken local inflammatory response, which is worthy of clinical application.

R971

首都衛(wèi)生發(fā)展科研專項(xiàng)項(xiàng)目（2022-2-7121）