目的 研究腦心通膠囊聯(lián)合注射用阿替普酶治療急性腦梗死的臨床療效。方法 選取2018年12月—2019年12月在周口市第一人民醫(yī)院治療的100例急性腦梗死患者。將所有患者隨機(jī)分為對(duì)照組和治療組，每組各50例。對(duì)照組患者給予注射用阿替普酶，推薦劑量為0.9 mg/kg，總劑量的10%在1 min內(nèi)先靜脈推入，剩余劑量在隨后60 min持續(xù)靜脈滴注。治療組在對(duì)照組基礎(chǔ)上口服腦心通膠囊，2粒/次，3次/d，治療時(shí)間為10 d。觀察兩組患者臨床療效，比較兩組的歐洲生活質(zhì)量（EuroQOL）評(píng)分、美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分、大腦平均血流速度、血清因子水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為72.5%、90.0%，治療組總有效率顯著較高（P<0.05）。治療后，兩組患者NIHSS評(píng)分顯著降低，EuroQOL評(píng)分顯著升高（P<0.05），且治療組NIHSS評(píng)分顯著低于治療組，EuroQOL評(píng)分顯著高于治療組（P<0.05）。治療后，兩組患者大腦前動(dòng)脈、后動(dòng)脈、中動(dòng)脈的平均血流速度顯著升高（P<0.05），且治療組大腦前動(dòng)脈、后動(dòng)脈、中動(dòng)脈的平均血流速度明顯高于對(duì)照組（P<0.05）。治療后，兩組血清神經(jīng)元特異性烯醇化酶（NSE）、髓鞘堿性蛋白（MBP）、超敏C反應(yīng)蛋白（hs-CRP）、同型半胱氨酸（Hcy）水平顯著降低（P<0.05）；并且治療組血清NSE、MBP、hs-CRP和Hcy水平均顯著低于對(duì)照組（P<0.05）。結(jié)論 腦心通膠囊聯(lián)合注射用阿替普酶治療急性腦梗死具有較好的療效，能夠改善患者神經(jīng)功能，提高患者生活質(zhì)量，升高大腦平均血流速度，降低血清因子水平。

Objective To study the efficacy of Naoxintong Capsules combined with Alteplase for injection in treatment of acute cerebral infarction. Methods Patients (100 cases) with acute cerebral infarction in Zhoukou First People's Hospital from December 2018 to December 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were given Alteplase for injection, the recommended dose was 0.9 mg/kg, 10% of the total dose was injected intravenously within 1 min, and the remaining dose was continuously infused in the following 60 min. Patients in the treatment group were po administered with Naoxintong Capsules on the basis of the control group, 2 grains/time, three times daily, treated for 10 d. After treatment, the clinical efficacies were evaluated, and EuroQOL scores, NIHSS scores, the mean blood flow velocity of cerebral artery, the serum factor levels in two groups were compared. Results After treatment, the total effective rate of the control group and the treatment group were 72.5% and 90.0%, respectively, and the total effective rate of the treatment group was significantly higher than that in the control group (P<0.05). After treatment, NIHSS score of two groups was significantly decreased, but EuroQol score of two groups was significantly increased (P<0.05), and the NIHSS score of the treatment group was significantly lower than that of the treatment group, but EuroQol score was significantly higher than that of the treatment group (P<0.05). After treatment, the average blood flow velocity of anterior cerebral artery, posterior artery and middle artery in two groups were significantly increased (P<0.05), and the average blood flow velocity of anterior cerebral artery, posterior artery and middle artery in treatment group was significantly higher than those in control group (P<0.05). After treatment, the levels of NSE, MBP, hs-CRP, and Hcy in two groups were significantly decreased (P<0.05), and the levels of NSE, MBP, hs-CRP, and Hcy in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Naoxintong Capsules combined with Alteplase for injection has clinical curative effect in treatment of acute cerebral infarction, can improve the neurological function of patients, improve the quality of life of patients, increase the average cerebral blood flow velocity, and reduce the serum level of inflammatory factors.

R971