目的 觀察血栓通聯(lián)合阿司匹林治療急性腦梗死的臨床療效及其安全性，為指導(dǎo)臨床合理用藥提供理論參考。方法 選取2011年12月-2013年12月青海省人民醫(yī)院收治的急性腦梗死患者68例，隨機(jī)分為對照組和治療組，每組34例，兩組治療期間均給予常規(guī)治療，對照組給予阿司匹林腸溶片100 mg/次，1次/d。治療組在對照組基礎(chǔ)上靜脈輸注注射用血栓通（凍干）500 mg加入0.9%氯化鈉注射液250 mL，1次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效，同時觀察兩組組織纖溶酶原激活物（t-PA）、血栓調(diào)節(jié)蛋白（TM）、組織纖溶酶原激活物抑制物（PAI）、D-二聚體（D-dimer）及血液流變學(xué)指標(biāo)變化。結(jié)果 治療后，治療組和對照組的總有效率分別為94.12%、91.18%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組的t-PA水平較治療前上升，TM、PAI、D-dimer水平均較治療前降低，同組治療前后差異有統(tǒng)計學(xué)意義（P<0.05、0.01）。治療組經(jīng)治療后，t-PA、TM、PAI的改善程度均優(yōu)于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05、0.01）。治療后，兩組各項(xiàng)血流動力學(xué)指標(biāo)均有不同程度的降低，同組治療前后比較差異均有統(tǒng)計學(xué)意義（P<0.05、0.01）。治療后，治療組紅細(xì)胞壓積、全血高切黏度、全血低切黏度、血漿高切黏度、纖維蛋白原均比對照組降低更加明顯，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 在常規(guī)治療的基礎(chǔ)上，給予血栓通治療急性腦梗死能顯著改善患者的神經(jīng)功能和血液流變學(xué)效應(yīng)，提高患者的生活質(zhì)量，且未見明顯的不良反應(yīng)，值得臨床推廣應(yīng)用。

Objective To observe the clinical efficacy and safety of Xueshuantong combined with aspirinon in treatment of acute cerebral infarction and to provide some knowledge for the rational use of drugs. Methods Acute cerebral infarction patients (68 cases) of Qinghai provincial people's Hospital from December 2011 to December 2013 were randomly divided into treatment and control groups, 34 cases in each group. The patients in both groups received conventional therapy. Patients in the control group were given aspirin enteric-coated metformin hydrochloride (100 mg/d). Patients in the treatment group were iv injected with Xueshuantong (lyophilization) 500 mg adding 0.9% Sodium Chloride Injection (250 mL) on the basis of the control group, once daily. All the patients were treated continuously for 14 d. The total clinical efficacy was observed, including the changes of t-PA, TM, PAI, D-dimer, and hemorheology in acute cerebral infarction patients. Results The total effective rates of treatment and control groups were 94.12% and 91.18%, respectively, with significant difference between two groups (P < 0.05). After treatment, the level of t-PA was higher, TM, PAI, and D-dimer were lower compared with those before treatment in the two groups, and the differences was statically significant in the same group before and after treatment (P < 0.05, 0.01). After treatment, the improvement degree of t-PA, TM, and PAI in the treatment group were better than those in the control group, with significant difference between the two groups (P < 0.05, 0.01). After treatment, all the hemorrheology indexes in two groups were obviously lower, and the differences was statically significant in the same group before and after treatment (P < 0.05, 0.01). After treatment, the blood hematocrit, high shear viscosity, low sheer viscosity, plasma hyperviscosity and fibrinogen were lower than those in the control group. There was significant difference between the two groups (P < 0.05). Conclusion The therapy of Xueshuantong for acute cerebral infarction on the basis of conventional treatment can significantly improve the neurological function and blood rheology effect, while can improve the life quality of patients without adverse reaction, which is worthy of clinical application. reaction, which is worthy of clinical application.