目的 探討復(fù)方腦肽節(jié)苷脂注射液聯(lián)合鹽酸替羅非班注射液治療急性腦梗死的臨床治療效果。方法 選取2020年2月—2021年10月在安陽市第六人民醫(yī)院治療的82例急性腦梗死患者，根據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，各41例患者。對(duì)照組靜脈滴注鹽酸替羅非班注射液，50 mL加入250 mL生理鹽水，1次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注復(fù)方腦肽節(jié)苷脂注射液，12 mL加入250 mL葡萄糖注射液充分稀釋，1次/d。兩組在治療14 d后統(tǒng)計(jì)療效。觀察兩組的臨床療效，比較兩組的美國國立衛(wèi)生研究院腦卒中量表（NIHSS）評(píng)分、彌散加權(quán)成像和Alberta卒中計(jì)劃早期CT評(píng)分（DWI-ASPECTS）和基底動(dòng)脈、椎動(dòng)脈的血流速度的變化以及血清胰高血糖素樣肽-1（GLP-1）、腦源性神經(jīng)營養(yǎng)因子（BDNF）、神經(jīng)特異性烯醇化酶（NSE）水平。結(jié)果 治療后，治療組患者的總有效率（90.24%）明顯高于對(duì)照組的總有效率（73.17%），差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組的NIHSS評(píng)分顯著降低，DWI-ASPECTS評(píng)分顯著升高（P＜0.05）；治療后，治療組的NIHSS評(píng)分比對(duì)照組低，DWI-ASPECTS評(píng)分比對(duì)照組高（P＜0.05）。治療后，兩組的基底動(dòng)脈、椎動(dòng)脈的血流速度顯著升高（P＜0.05）；治療組的基底動(dòng)脈、椎動(dòng)脈的血流速度比對(duì)照組升高更明顯，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組的血清GLP-1、BDNF水平明顯增多，血清NSE水平明顯減少（P＜0.05）；治療組的血清GLP-1、BDNF水平明顯高于對(duì)照組，NSE水平明顯低于對(duì)照組（P＜0.05）。結(jié)論 復(fù)方腦肽節(jié)苷脂注射液聯(lián)合鹽酸替羅非班注射液可提高急性腦梗死的療效，改善神經(jīng)功能、腦部血流和血清GLP-1、BDNF、NSE水平，安全性較好。

Objective To investigate the clinical efficacy of Compound Porcine Cerebroside and Ganglioside Injection combined with Tirofiban Hydrochloride Injection in treatment of acute cerebral infarction. Methods Patients (82 cases) with acute cerebral infarction in Anyang People's Hospital of No. 6 from February 2020 to October 2015 were divided into control and treatment groups according to the random number table method, and each group had 41 cases. Patients in the control group were iv administered with Tirofiban Hydrochloride Injection, 50 mL added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Compound Porcine Cerebroside and Ganglioside Injection on the basis of the control group, 12 mL added into glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS score, DWI-ASPECTS score, the blood flow velocity of basilar artery and vertebral artery, and the levels of GLP-1, BDNF, and NSE in two groups were compared. Results After treatment, the total effective rate of the treatment group (90.24%) was significantly higher than 73.17% of the control group (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but DWI-ASPECTS scores in two groups were significantly increased (P < 0.05). After treatment, the NIHSS score of the treatment group was lower than that of the control group, but the DWI-ASPECTS score was higher than that of the control group (P < 0.05). After treatment, the blood flow velocity of basilar artery and vertebral artery in two groups were significantly increased (P < 0.05). The blood flow velocity of basilar artery and vertebral artery in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the levels of GLP-1 and BDNF in two groups were significantly increased, but the level of NSE in two groups were significantly decreased (P < 0.05). The levels of GLP-1 and BDNF in the treatment group were significantly higher than those in the control group, but the level of NSE in the treatment group was significantly lower than those in the control group (P < 0.05). Conclusion Compound Porcine Cerebroside and Ganglioside Injection combined with Tirofiban Hydrochloride Injection can improve the therapeutic effect, neurological function, cerebral blood flow, and levels of GLP-1, BDNF, and NSE, with good safety.

R971

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目(LHGJ20190555)