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(duì)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(duì)象，按治療方法不同將其分為對(duì)照組（n＝47）和試驗(yàn)組（n＝47）。對(duì)照組患者阿替普酶進(jìn)行靜脈溶栓治療，試驗(yàn)組患者在對(duì)照組基礎(chǔ)上聯(lián)合丁苯酞序貫療法進(jìn)行治療。比較兩組臨床療效、治療前后神經(jīng)功能評(píng)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(yīng)蛋白（hs-CRP）、白細(xì)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(píng)分（OHS）情況。結(jié)果 治療前兩組患者美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分比較，差異不顯著（P＞0.05）；試驗(yàn)組治療后NIHSS評(píng)分明顯低于對(duì)照組（P＜0.05）。試驗(yàn)組臨床總有效率（91.49%）明顯高于對(duì)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(yàn)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(duì)照組（P＜0.05）。試驗(yàn)組OHS評(píng)分1級(jí)、2級(jí)患者占比顯著高于對(duì)照組（P＜0.05）。結(jié)論 對(duì)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(jìn)行治療效果較好，可以明顯降低患者機(jī)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(yù)后良好，值得在臨床進(jìn)行推廣應(yīng)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(guó)家自然科學(xué)基金資助項(xiàng)目（81971092）