目的 觀察丁苯酞氯化鈉注射液、丁苯酞軟膠囊聯(lián)合注射用阿替普酶治療急性缺血性腦梗死的臨床療效。方法 選取2013年10月-2016年3月在濰坊市中醫(yī)院的缺血性腦梗死患者60例作為研究對(duì)象，所有患者隨機(jī)分為對(duì)照組和治療組，每組各30例。對(duì)照組給予注射用阿替普酶0.9 mg/kg，首先1 min內(nèi)靜脈推注總量的10%，然后60 min靜脈泵入剩余90%，最大劑量90 mg。治療組在對(duì)照組基礎(chǔ)上靜脈滴注丁苯酞氯化鈉注射液100 mL/次，2次/d，連續(xù)治療14 d，然后改為口服丁苯酞軟膠囊0.2 g/次，3次/d，連續(xù)治療90 d。觀察兩組的臨床療效，比較兩組的美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分和血清基質(zhì)金屬蛋白酶-9（MMP-9）水平情況。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為83.3%、93.3%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療7、14、90 d后，兩組NIHSS評(píng)分均顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且同期治療組這些觀察指標(biāo)的下降程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療7、14 d后，兩組MMP-9水平均顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且同期治療組這些觀察指標(biāo)的下降程度明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 丁苯酞氯化鈉注射液、丁苯酞軟膠囊聯(lián)合注射用阿替普酶治療急性缺血性腦梗死具有較好的臨床療效，可改善神經(jīng)功能損傷，降低血清MMP-9水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Butylphthalide and Sodium Chloride Injection and Butylphthalide Soft Capsules combined with Alteplase for injection in treatment of acute ischemic cerebral infarction. Methods Patients (60 cases) with acute ischemic cerebral infarction in Weifang Traditional Chinese Hospital from October 2013 to March 2016 were randomly divided into control and treatment groups, and each group had 30 cases. Patients in the control group were given Alteplase for injection 0.9 mg/kg, first of all, intravenous bolus total dose 10% within 1 min, then 60 min intravenous infusion of the remaining 90%, the maximum dose 90 mg. Patients in the treatment group were iv administered with Butylphthalide and Sodium Chloride Injection on the basis of the control group, 100 mL/time, twice daily, treated for 14 d, then changed to po administered with Butylphthalide Soft Capsules, 0.2 g/time, three times daily, and were treated for 90 d. After treatment, the clinical efficacies were evaluated, and NHISS scores and serum MMP-9 levels in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.3% and 93.3%, respectively, and there was difference between two groups (P<0.05). After treatment for 7, 14, and 90 d, the NIHSS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment for 7 and 14 d, the MMP-9 levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Butylphthalide and Sodium Chloride Injection and Butylphthalide Soft Capsules combined with Alteplase for injection has clinical curative effect in treatment of acute ischemic cerebral infarction, can improve nerve function damage, decrease serum MMP-9 levels, which has a clinical application value.