目的 探討注射用丹參多酚酸對(duì)新發(fā)缺血性腦卒中患者血運(yùn)重建后腦缺血再灌注損傷的保護(hù)作用。方法 選取2020年1月—2022年6月河北省唐山市古冶區(qū)中醫(yī)醫(yī)院收治的新發(fā)缺血性腦卒中并血運(yùn)重建后發(fā)生腦缺血再灌注損傷的患者124例為研究對(duì)象，根據(jù)治療藥物不同將患者分為對(duì)照組和試驗(yàn)組，每組各62例。對(duì)照組患者在常規(guī)治療和溶栓/取栓治療基礎(chǔ)上加用丹紅注射液（40 mL丹紅注射液＋250 mL 0.9%氯化鈉注射液，靜脈滴注，每日1次），試驗(yàn)組患者在常規(guī)治療和溶栓/取栓治療基礎(chǔ)上加用注射用丹參多酚酸（0.13 g注射用丹參多酚酸＋250 mL 0.9%氯化鈉注射液，靜脈滴注，每日1次），兩組均連續(xù)治療14 d。分別于治療前及治療14 d測(cè)定兩組患者血清中腦型肌酸激酶同工酶（CK-BB）、中樞神經(jīng)特異性蛋白S-100β（S-100β）、腫瘤壞死因子（TNF-α）、谷氨酸（Glu）、轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）、白細(xì)胞介素-1（IL-1）與白細(xì)胞介素-10（IL-10）水平，核磁共振（MRI）檢查并計(jì)算相對(duì)表觀擴(kuò)散系數(shù)值（rADC），根據(jù)美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)估治療效果，統(tǒng)計(jì)不良反應(yīng)。結(jié)果 治療前，兩組患者各項(xiàng)指標(biāo)比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）；治療14 d，兩組患者血清CK-BB、S-100β、TNF-α、TGF-β1、Glu、IL-1、IL-10水平均較本組治療前顯著降低（P＜0.05），且試驗(yàn)組各項(xiàng)指標(biāo)水平均低于對(duì)照組（P＜0.05）；治療14 d，兩組患者rADC值均較本組治療前顯著升高（P＜0.05），且試驗(yàn)組顯著高于對(duì)照組（P＜0.05）。對(duì)照組治療總有效率為64.52%，試驗(yàn)組治療總有效率為74.19%，兩組比較差異顯著（P＜0.05）；兩組不良反應(yīng)發(fā)生率比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。結(jié)論 注射用丹參多酚酸可以有效減輕新發(fā)腦卒中患者血運(yùn)重建后腦缺血再灌注損傷，提高療效，對(duì)腦組織有保護(hù)作用。

Objective To investigate the protective effect of Salvianolic Acid for Injection on cerebral ischemia-reperfusion injury after revascularization in newly diagnosed ischemic stroke patients. Methods A total of 124 patients with new ischemic stroke and cerebral ischemia-reperfusion injury after blood circulation reconstruction who were admitted to Guye District Hospital of Traditional Chinese Medicine in Tangshan from January 2020 to June 2022 were selected as the research objects. According to different therapeutic drugs, the patients were divided into control group and experimental group, with 62 cases in each group. The control group patients were treated with Danhong Injection (40 mL Danhong Injection + 250 mL 0.9% Sodium Chloride Injection, intravenous drip, once a day) on the basis of routine treatment and thrombolysis/thrombectomy treatment. The experimental group patients were treated with Salvianolic Acid for Injection (0.13 g Salvianolic Acid for Injection + 250 mL 0.9% Sodium Chloride Injection, intravenous drip, once a day) on the basis of routine treatment and thrombolysis/thrombectomy treatment. Both groups were continuously treated for 14 days. Serum levels of midbrain creatine kinase isozyme (CK-BB), central nerve specific protein S-100 β (S-100 β), tumor necrosis factor-α (TNF-α), glutamic acid (Glu), transforming growth factor- β 1 (TGF-β1), interleukin-1 (IL-1) and interleukin 10 (IL-10) were measured before treatment and 14 days after treatment in the two groups. Nuclear Magnetic Resonance Imaging (MRI) was examined and relative apparent diffusion coefficient (rADC) was calculated. Treatment effect was evaluated according to the National Institutes of Health Stroke Scale (NIHSS), and adverse reactions was observed. Results Before treatment, there was no statistically significant difference in various indicators between the two groups of patients (P＞0.05). After 14 days of treatment, serum levels of CK-BB, S-100 β, TNF-α, Glu, TGF- β 1, IL-1 and IL-10 were significantly reduced compared to before treatment in same group (P＜0.05). Levels of above various indicators in the experimental group were lower than those in the control group (P＜0.05). After 14 days of treatment, the rADC values of both groups of patients were significantly higher than before treatment (P＜0.05), and the experimental group was significantly higher than the control group (P＜0.05). The total effective rate of the control group was 64.52%, while the total effective rate of the experimental group was 74.19%. The difference between the two groups was significant (P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P＞0.05). Conclusion Salvianolic Acid for Injection can effectively alleviate cerebral ischemiareperfusion injury after revascularization in newly diagnosed stroke patients, improve therapeutic efficacy, and have a protective effect on brain tissue.

R971