目的 探討注射用丹參多酚酸聯(lián)合注射用阿替普酶靜脈溶栓治療急性腦梗死的安全性及臨床療效。方法 選取太原鋼鐵（集團(tuán)）有限公司總醫(yī)院神經(jīng)內(nèi)科于2017年3月——2018年3月收治的急性缺血性腦卒中患者92例，分為對照組及觀察組。對照組42例，給予靜脈溶栓治療，10%注射用阿替普酶（0.9 mg/kg）靜推，其余90%在1 h內(nèi)靜點(diǎn)完畢，隨后靜脈滴注生理鹽水250 mL；24 h后給予缺血性卒中的基礎(chǔ)用藥。觀察組50例，在相同方法靜脈溶栓后立刻給予注射用丹參多酚酸0.13 g加入250 mL生理鹽水中，靜脈滴注，1次/d，連續(xù)用藥14 d；溶栓24 h后給予缺血性卒中的基礎(chǔ)用藥。所有入選患者分別于治療前、治療后14、90 d記錄美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、Barthel（BI）指數(shù)、改良Rankin量表（mRS）評分并記錄不良反應(yīng)事件。結(jié)果 治療前，對照組、觀察組的NIHSS評分、mRS評分、BI指數(shù)未見顯著差異。與治療前比較，用藥后14、90 d，對照組、觀察組的NIHSS評分、mRS評分均顯著下降，BI指數(shù)顯著升高（P<0.05）；用藥后14 d，兩組患者的NIHSS評分、mRS評分、BI指數(shù)未見顯著差異；用藥后90 d，觀察組的NIHSS評分、mRS評分較對照組顯著降低，BI指數(shù)顯著升高（P<0.05）。兩組患者用藥后均未出現(xiàn)顱內(nèi)出血。結(jié)論 注射用丹參多酚酸聯(lián)合注射用阿替普酶靜脈溶栓治療急性腦梗死患者安全性高，且明顯改善患者預(yù)后。

Objective To study the safety and clinical efficacy of intravenous thrombolysis with Salvianolic Acids for Injection and Alteplase for Injection in the treatment of acute cerebral infarction. Methods 92 patients with acute cerebral infarction were selected and divided into control group and experimental group. 42 cases in control group were given rt-PA therapy with atenopramide for 24 hours, and 50 cases in experimental group were given SAFI 100 mg + 0.9% sodium chloride 250 mL immediately after intravenous thrombolysis with the same method, once a day for 14 days, followed by ischemia 24 hours after thrombolysis. Basic drugs for stroke. The National Institutes of Health Stroke Scale (NIHSS), Activity of Daily Living (BI), Modified Rankin Scale (mRS) and adverse events were recorded before and 14 and 90 days after treatment. Results Before treatment, there were no significant differences in NIHSS score, mRS score and BI index between the control group and the observation group. Compared with before treatment, NIHSS score and mRS score of control group and observation group decreased significantly and BI index increased significantly at 14 and 90 days after treatment (P<0.05); NIHSS score, mRS score and BI index of two groups had no significant difference at 14 days after treatment; NIHSS score and mRS score of observation group decreased significantly and BI index increased significantly at 90 days after treatment compared with control group (P<0.05). There was no intracranial hemorrhage in both groups. Conclusion Intravenous thrombolysis with SAFI and rt-PA is safe and can improve the prognosis of patients with acute cerebral infarction.