目的 觀察復(fù)方血栓通膠囊聯(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6月—2020年6月天津市北辰醫(yī)院接收89例急性腦梗死患者，按照門診單雙號(hào)將所有患者分為對(duì)照組（45例）和治療組（44例）。對(duì)照組給予注射用阿替普酶，劑量按0.9 mg/kg計(jì)算，最大劑量<90 mg，首先于1 min內(nèi)靜脈推注藥量10%，其余90%在0.9%氯化鈉溶液100 mL稀釋后于1 h內(nèi)靜脈滴注完畢。治療組于對(duì)照組基礎(chǔ)上口服復(fù)方血栓通膠囊，3粒/次，3次/d，連續(xù)治療10 d。兩組治療10 d后進(jìn)行療效比較。觀察兩組治療效果，比較兩組血清學(xué)指標(biāo)和生活能力。結(jié)果 治療后，治療組的總有效率（97.73%）較對(duì)照組的總有效率（82.22%）高，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組神經(jīng)元特異性烯醇化酶（NSE）、超敏C反應(yīng)蛋白（hs-CRP）、可溶性細(xì)胞間黏附分子-1（sICAM-1）水平均較治療前下降（P<0.05），且治療組NSE、hs-CRP、sICAM-1水平低于對(duì)照組（P<0.05）。隨訪90 d后，兩組改良RanKin量表（mRS）評(píng)分均較治療前降低（P<0.05），治療組mRS評(píng)分低于對(duì)照組（P<0.05）。結(jié)論 復(fù)方血栓通膠囊聯(lián)合注射用阿替普酶治療急性腦梗死的療效確切，可降低患者血清NSE、hs-CRP、sICAM-1水平，提高其生活能力，促進(jìn)預(yù)后，且不增加用藥安全性風(fēng)險(xiǎn)。

Objective To observe the effect of Compound Xueshuantong Capsules combined with Alteplase for injection in treatment of acute cerebral infarction.Methods Patients (89 cases) with acute cerebral infarction in Tianjin Beichen Hospital from June 2018 to June 2020 were randomly divided into the control group (45 cases) and the treatment group (44 cases). Patients in the control group were given Alteplase for injection, 0.9 mg/kg, maximum dose<90 mg, first, 10% of the drug was injected intravenously within 1 min, and the remaining 90% was diluted with 100 mL 0.9% sodium chloride solution, and then intravenous drip was completed within 1 h. Patients in the treatment group were po administered with Compound Xueshuantong Capsules on the basis of the control group, 0.3 grains/time, three times daily, treated for 10 d. After treatment for 10 d, the clinical efficacies were evaluated, and serological indicators and living ability in two groups were compared.Results After treatment, the total effective rate of the treatment group (97.73%) was higher than that of the control group (82.22%), and the difference was statistically significant (P<0.05). After treatment, the levels of NSE, hs-CRP, and sICAM-1 in two groups were lower than those before treatment (P<0.05), and the levels of NSE, hs-CRP, and sICAM-1 in the treatment group were lower than those in the control group (P<0.05). After 90 d of follow-up, the mRS scores of two groups were lower than those before treatment (P<0.05), and the mRS scores of the treatment group were lower than those of the control group (P<0.05).Conclusion Compound Xueshuantong Capsules combined with Alteplase for injection has certain efficacy in the treatment of acute cerebral infarction, can reduce the serum levels of NSE, hs-CRP, and sICAM-1 of patients, improve their living ability, promote the prognosis, without increasing the risk of medication safety.

R971

天津市北辰區(qū)科技計(jì)劃項(xiàng)目（SHGY-2020033）