目的 分析果糖二磷酸鈉聯(lián)合阿替普酶治療急性腦梗死的臨床效果。方法 選取2017年1月-2019年1月安陽市第二人民醫(yī)院收治的急性腦梗死患者93例，隨機分為對照組（47例）和治療組（46例）。對照組患者iv注射用阿替普酶，0.9 mg/kg，其中10%藥量靜脈推注1 min，剩下90%的藥物靜脈泵注1 h。治療組在對照組的基礎(chǔ)上口服果糖二磷酸鈉片，4片/次，3次/d。兩組患者均治療2周。觀察兩組患者臨床療效，同時比較治療前后兩組患者生活能力和神經(jīng)功能及血管內(nèi)皮損傷情況。結(jié)果 治療后，對照組和治療組臨床有效率分別為78.72%和91.30%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者Barthel明顯升高（P<0.05），而NIHSS評分明顯降低（P<0.05），且治療組Barthel、NIHSS評分改善效果明顯優(yōu)于對照組（P<0.05）。治療后，兩組患者sTM和vWF水平均顯著降低（P<0.05），且治療組明顯低于對照組（P<0.05）。結(jié)論 果糖二磷酸鈉聯(lián)合阿替普酶應(yīng)治療急性腦梗死患者具有良好臨床效果，可明顯提高患者生活能力，改善神經(jīng)功能和血管內(nèi)皮損傷。

Objective To analyze the clinical effect of fructose diphosphate sodium combined with alteplase in treatment of acute cerebral infarction. Methods Patients (93 cases) with acute cerebral infarction in the Second People's Hospital of Anyang from January 2017 to January 2019 were randomly divided into control (47 cases) and treatment (46 cases) groups. Patients in the control group were iv administered with Alteplase for injection, 0.9 mg/kg, 10% of the drug was injected intravenously for 1 min, and 90% of the drug was pumped intravenously for 1 h. Patients in the treatment group were po administered with Fructose Diphosphate Sodium Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the living ability, the neurological function, and the injury of vascular endothelial in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 78.72% and 91.30% respectively, and there were differences between two groups (P<0.05). After treatment, the Barthel score in two groups was significantly increased (P<0.05), the NIHSS score was significantly decreased (P<0.05), the Barthel and NIHSS score in the treatment group was significantly better than those in the control group (P<0.05). After treatment, the sTM and vWF level in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion fructose diphosphate sodium combined with alteplase in treatment of acute cerebral infarction has better clinical therapeutic effect, can obviously improve the living ability of patients, and improve neurological function and vascular endothelial injury.

R971