目的 觀察注射用丹參多酚酸對(duì)急性缺血性腦卒中患者細(xì)胞間黏附因子-1（ICAM-1）、膽紅素及早期神經(jīng)功能的影響，探討注射用丹參多酚酸可能的作用機(jī)制。方法 回顧性以2020年1月—2020年10月在保定市第一中心醫(yī)院神經(jīng)內(nèi)科住院的急性缺血性腦卒中患者100例為研究對(duì)象，根據(jù)治療措施不同分為對(duì)照組和試驗(yàn)組，每組各50例。對(duì)照組為常規(guī)抗栓治療，試驗(yàn)組在對(duì)照組基礎(chǔ)上加用注射用丹參多酚酸，每次取0.13 g加入0.9%氯化鈉注射液250 mL中稀釋，靜脈滴注，每天1次。兩組均連續(xù)治療14 d。在入院第1天、第14天分別收集患者血清，測定ICAM-1、膽紅素水平，并應(yīng)用美國國立衛(wèi)生研究院卒中量表（NIHSS）評(píng)估患者的神經(jīng)功能，評(píng)定兩組治療療效，并觀察治療期間不良反應(yīng)發(fā)生情況。結(jié)果 兩組治療前ICAM-1、膽紅素水平及NIHSS評(píng)分比較，差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。兩組治療后NIHSS評(píng)分均較本組治療前顯著降低（P＜0.05），且試驗(yàn)組NIHSS評(píng)分明顯低于對(duì)照組（P＜0.05）。治療后，對(duì)照組膽紅素水平較本組治療前顯著降低（P＜0.05），但試驗(yàn)組膽紅素水平較本組治療前顯著升高，且高于對(duì)照組治療后水平（P＜0.05）；兩組ICAM-1水平均較本組治療前顯著降低（P＜0.05），且試驗(yàn)組ICAM-1水平下降程度較對(duì)照組顯著（P＜0.05）。試驗(yàn)組的治療總有效率高于對(duì)照組（P＜0.05）。結(jié)論 注射用丹參多酚酸可能通過降低ICAM-1水平，升高膽紅素水平發(fā)揮神經(jīng)保護(hù)作用，改善缺血性腦卒中患者神經(jīng)功能。

Objective To observe the effects of Salvianolic Acid for Injection on intercellular cell adhesion molecule-1 (ICAM-1) bilirubin and early neurological function in patients with acute ischemic stroke, and to explore the possible mechanism of action of Salvianolic Acid for Injection. Methods A total of 100 patients with acute ischemic stroke hospitalized in Baoding NO.1 Central Hospital from January 2020 to October 2020 were retrospectively taken as the research objects. According to different treatment measures, they were divided into the control group and the experimental group, with 50 cases in each group. Patients in the control group received routine antithrombotic treatment, while patients in the experimental group received Salvianolic Acid for Injection on the basis of the control group. 0.13 g Salvianolic Acid for Injection was added to 250 mL of 0.9% Sodium Chloride Injection and diluted intravenously once a day. Both groups were treated continuously for 14 days. On the first and 14th day of admission, serum samples were collected from patients, and ICAM-1 and bilirubin levels were measured. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the patient's neurological function, the treatment efficacy of the two groups were evaluated, and the occurrence of adverse reactions were observed during the treatment period. Results There was no statistically significant difference in ICAM-1, bilirubin levels, and NIHSS scores between the two groups before treatment (P＞0.05). After treatment, the NIHSS score of both groups significantly decreased compared to before treatment in same group (P＜0.05), and the NIHSS score of the experimental group was significantly lower than that of the control group (P＜0.05). After treatment, the bilirubin level in the control group significantly decreased compared to before treatment in same group (P＜0.05), but the bilirubin level in the experimental group significantly increased compared to before treatment in same group, and was higher than the level in the control group after treatment (P＜0.05). The level of ICAM-1 in both groups were significantly reduced compared to before treatment in same group (P＜0.05), and the level of ICAM-1 in the experimental group decreased significantly compared to the control group (P＜0.05). The total effective rate of treatment in the experimental group was higher than that in the control group (P＜0.05). Conclusion Salvianolic Acid for Injection may exert neuroprotective effects by reducing ICAM-1 level and increasing bilirubin level, thereby improving neurological function in patients with ischemic stroke.

R971

河北省醫(yī)學(xué)研究重點(diǎn)課題計(jì)劃項(xiàng)目（20181487）