目的 探討阿替普酶聯(lián)合丁苯酞序貫療法治療急性腦梗死患者對其病情的影響。方法 選取海南省儋州市人民醫(yī)院神經(jīng)內(nèi)科2020年9月—2021年3月期間收治的94例急性缺血性腦卒中患者作為研究對象，按治療方法不同將其分為對照組（n＝47）和試驗組（n＝47）。對照組患者阿替普酶進行靜脈溶栓治療，試驗組患者在對照組基礎上聯(lián)合丁苯酞序貫療法進行治療。比較兩組臨床療效、治療前后神經(jīng)功能評分、血清人泛素C末端水解酶（UCH-L1）、血清膠質(zhì)纖維酸性蛋白（GFAP）水平變化、血清炎性因子水平變化［高敏C反應蛋白（hs-CRP）、白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、正五聚蛋白3（PTX-3）］以及牛津殘障評分（OHS）情況。結果 治療前兩組患者美國國立衛(wèi)生研究院卒中量表（NIHSS）評分比較，差異不顯著（P＞0.05）；試驗組治療后NIHSS評分明顯低于對照組（P＜0.05）。試驗組臨床總有效率（91.49%）明顯高于對照組（74.47%）（P＜0.05）。治療前，兩組患者血清UCH-L1、GFAP、hs-CRP、IL-6、TNF-α、PTX-3水平比較，差異均不顯著（P＞0.05）；試驗組治療后血清UCH-L1、GFAP、hs-CRP、IL-6、TNF-α、PTX-3水平均顯著低于對照組（P＜0.05）。試驗組OHS評分1級、2級患者占比顯著高于對照組（P＜0.05）。結論 對急性缺血性腦卒中患者采用阿替普酶聯(lián)合丁苯酞序貫療法進行治療效果較好，可以明顯降低患者機體內(nèi)UCH-L1、GFAP含量，抑制炎性水平，改善神經(jīng)功能缺損程度，且病情預后良好，值得在臨床進行推廣應用。

Objective To explore the effect of sequential therapy with ateplase combined with butyphthalide on the condition of patients with acute cerebral infarction. Methods A total of 94 patients with acute cerebral infarction admitted to the Department of Neurology from September 2020 to March 2021 were selected as the study subjects and divided into control group (n = 47) and observation group (n = 47) according to the dynamic randomization method. The control group was treated with intravenous thrombolysis, and the patients in the observation group were treated with sequential therapy on the control basis. The clinical efficacy, neurological function scores before and after treatment, serum human ubiquitin C terminal hydrolase (UCH-L1), serum glial fibrillary acidic protein (GFAP) levels, serum inflammatory factor levels [hypersensitive C reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), n-pentamerin 3 (PTX-3)] and oxford disability score (OHS) were compared. Results After treatment, the neurological deficit score (NIHSS) points] in the observation group was significantly lower than that in the control group (P < 0.05). The clinical efficacy of the observation group (91.49%) was significantly higher than that of the control group (74.47%) (P < 0.05). After treatment serum UCH-L1, GFAP, hs-CRP, IL-6, TNF- α, PTX-3 levels were significantly lower than those in the control group . Level 1\ and level 2\ of OHS in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion Ateplase combined with butyphthalide sequential therapy has a good therapeutic effect on patients with acute cerebral infarction. It can significantly reduce the content of UCH-L1 and GFAP in the body of patients, inhibit the inflammatory level, improve the degree of neural function defect, and has a good prognosis. It is worth promoting in clinical application.

R971

國家自然科學基金資助項目（81971092）