目的 探討注射用丹參多酚酸對發(fā)病48 h～14 d的缺血性腦卒中患者的療效及對患者血脂蛋白相關(guān)性磷脂酶A₂（Lp-PLA₂）及氧化修飾型低密度脂蛋白（ox-LDL）的影響。方法 選擇2020年1月—2022年6月安陽市人民醫(yī)院收治的發(fā)病48 h～14 d入院的260例缺血性腦卒中患者，按照治療方案不同分為對照組和試驗組，每組各130例，兩組均給予缺血性腦卒中的常規(guī)治療，對照組在常規(guī)治療基礎(chǔ)上給予注射用血塞通（凍干），每次400 mg加入0.9%氯化鈉注射液250 mL，靜脈滴注，每天1次；試驗組在對照組基礎(chǔ)上給予注射用丹參多酚酸，每次取0.13 g加入0.9%氯化鈉注射液250 mL，靜脈滴注，每天1次。兩組療程均為14 d。比較兩組臨床療效，分別于治療前及治療14 d后采用美國國立衛(wèi)生研究院卒中量表（NIHSS）評分量表進行神經(jīng)功能缺損評估，采用日常生活能力量表（ADL）評分進行日常生活能力評估，采用改良Rankin量表（mRS）評分評價神經(jīng)功能恢復(fù)情況，治療前及治療14 d后測定兩組患者血漿Lp-PLA₂及血清ox-LDL水平。觀察治療期間兩組患者不良反應(yīng)發(fā)生情況。結(jié)果 試驗組總有效率為93.85%，顯著高于對照組的87.69%（P＜0.05）。治療前兩組NIHSS、mRS、ADL評分比較，差異均無統(tǒng)計學(xué)意義（P＞0.05）；治療14 d后兩組NIHSS、mRS評分均較本組治療前顯著降低（P＜0.05），且試驗組顯著低于對照組（P＜0.05）；治療后，兩組ADL評分均較本組治療前顯著升高（P＜0.05）；且試驗組顯著高于對照組（P＜0.05）。治療前兩組Lp-PLA₂及ox-LDL水平比較，差異均無統(tǒng)計學(xué)意義（P＞0.05）；在治療14 d后兩組Lp-PLA₂及ox-LDL水平均較本組治療前顯著降低（P＜0.05），且試驗組顯著低于對照組（P＜0.05）。治療期間，兩組均未發(fā)生明顯不良反應(yīng)。結(jié)論 注射用丹參多酚酸能有效降低發(fā)病48 h～14 d的缺血性腦卒中患者血Lp-PLA₂及ox-LDL水平，能夠改善臨床癥狀，提高生活質(zhì)量，且安全性好。

Objective To investigate the therapeutic effect of Salvianolic Acid for Injection on cerebral ischemic stroke patients from 48 h to 14 d after onset, and the effect on lipoprotein related phospholipase A₂ (Lp-PLA₂) and oxidized low-density lipoprotein (ox-LDL). Methods From January 2020 to June 2022, 260 patients with cerebral ischemic stroke admitted to Anyang People's Hospital from 48 hours to 14 days after onset were selected. According to different treatment schemes, they were divided into a control group and a experimental group, with 130 cases in each group. Both groups were given conventional treatment for ischemic stroke. Patients in the control group were given Xuesaitong for Injection (freeze-dried) on the basis of conventional treatment, with 400 mg of 0.9% Sodium Chloride Injection 250 mL added each time, intravenous drip, once a day. Patients in the experimental group were given Salvianolic Acid for Injection on the basis of the control group, 0.13 g was taken each time and 250 mL of 0.9% Sodium Chloride Injection was added, intravenous drip once a day. Both groups of treatments lasted for 14 days. The clinical efficacy of two groups was compared, the National Institutes of Health Stroke Scale (NIHSS) was used to assess neurological deficits before and 14 days after treatment. The Activities of Daily Living scale (ADL) was used to assess daily living abilities. The Modified Rankin Scale (mRS) was used to evaluate neurological recovery. Plasma Lp-PLA₂ and serum ox-LDL levels were measured before and 14 days after treatment in both groups of patients. The occurrence of adverse reactions in both groups of patients was observed during the treatment period. Results The total effective rate of the experimental group was 93.85%, significantly higher than 87.69% of the control group (P＜0.05). There was no statistically significant difference in NIHSS, mRS, and ADL scores between the two groups before treatment (P＞0.05). After 14 days of treatment, the NIHSS and mRS scores of both groups were significantly reduced compared to before treatment in same group (P＜0.05), and the experimental group was significantly lower than the control group (P＜0.05). After treatment, the ADL scores of both groups significantly increased compared to before treatment in same group (P＜0.05), and the experimental group was significantly higher than the control group (P＜0.05). There was no statistically significant difference in the levels of Lp-PLA₂ and ox-LDL between the two groups before treatment (P＞0.05). After 14 days of treatment, the levels of Lp-PLA₂ and ox-LDL in both groups were significantly reduced compared to before treatment in same group (P＜0.05), and the experimental group was significantly lower than the control group (P＜0.05). During the treatment period, neither group experienced any significant adverse reactions. Conclusion Salvianolic Acid for Injection can effectively reduce the levels of Lp-PLA₂ and ox-LDL in blood of cerebral ischemic stroke patients from 48 hours to 14 days after onset, improve clinical symptoms, improve quality of life, and have good safety.

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