目的 探討依達(dá)拉奉右莰醇注射用濃溶液聯(lián)合阿加曲班治療急性腦梗死的臨床療效。方法 選取2020年3月—2022年3月北京京煤集團(tuán)總醫(yī)院收治的126例急性腦梗死患者，按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各63例。對(duì)照組使用阿加曲班注射液，開始2 d內(nèi)以2.5 mg/h的速率持續(xù)靜脈內(nèi)泵入；隨后5 d內(nèi)調(diào)整為10 mg/次，2次/d，分別于早晚靜脈滴注，每次給藥時(shí)間為3 h。治療組在對(duì)照組治療基礎(chǔ)上靜脈滴注依達(dá)拉奉右莰醇注射用濃溶液，每次將15 mL加入生理鹽水100 mL中充分稀釋后30 min內(nèi)滴完，2次/d。兩組療程為14 d。觀察兩組療效，比較治療前后兩組相關(guān)量表[美國(guó)國(guó)立衛(wèi)生研究院卒中量表（NIHSS）、腦卒中自我效能問卷（SSEQ）、腦卒中專門化生存質(zhì)量量表（SS-QOL）]評(píng)分及血漿纖溶酶-抗纖溶酶復(fù)合物（PAP）、凝血酶抗凝血酶復(fù)合物（TAT）、纖維蛋白降解產(chǎn)物（FDP）、蛋白C活性（PC）水平。并統(tǒng)計(jì)兩組不良反應(yīng)情況。結(jié)果 治療后，治療組總有效率是93.65%，顯著高于對(duì)照組的80.95%（P＜0.05）。治療后，兩組各時(shí)間點(diǎn)NIHSS評(píng)分均較治療前顯著降低（P＜0.05），且治療后，治療組各時(shí)間點(diǎn)NIHSS評(píng)分均顯著低于對(duì)照組（P＜0.05）。治療后，兩組SSEQ、SS-QOL評(píng)分均顯著增加（P＜0.05），且以治療組增加更顯著（P＜0.05）。治療后兩組血漿PAP、TAT、FDP、PC水平均顯著下降（P＜0.05）；且治療后，治療組血漿PAP、TAT、FDP、PC水平均顯著低于對(duì)照組（P＜0.05）。治療過程中，治療組和對(duì)照組不良反應(yīng)發(fā)生率分別是6.35%、4.76%，兩組比較差異沒有統(tǒng)計(jì)學(xué)意義。結(jié)論 依達(dá)拉奉右莰醇注射用濃溶液聯(lián)合阿加曲班治療急性腦梗死可取得顯著療效，能安全有效地改善患者血液高凝狀態(tài)，抑制血栓形成，并可發(fā)揮良好的神經(jīng)保護(hù)作用，提高患者自我效能感和生活質(zhì)量，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Edaravone and Dexborneol Concentrated Solution for injection combined with agatroban in treatment of acute cerebral infarction. Methods A total of 126 patients with acute cerebral infarction admitted to Beijing Jingmei Group General Hospital from March 2020 to March 2022 were selected and divided into control group and treatment group according to random number table method, with 63 cases in each group. Patients in the control group were given Agattriban Injection, which was continuously pumped intravenously at a rate of 2.5 mg/h within 2 d. Then, the dosage was adjusted to 10 mg/time within 5 d, twice daily, and intravenous infusion was given in the morning and evening, and the administration time was 3 h each time. Patients in the treatment group were iv administered with Edaravone and Dexborneol Concentrated Solution for injection on the basis of the control group, and 15 mL was added into 100 mL normal saline for full dilution within 30 min, twice daily. The treatment course of the two groups was 14 d. After treatment, the clinical efficacy was evaluated, and the scores of the National Institutes of Health Stroke Scale (NIHSS), Stroke Self-Efficacy Questionnaire (SSEQ), Stroke Specialized Quality of Life Scale (SS-QOL), plasma plasminase-anti-plasminase complex (PAP), thrombin anti-thrombin complex (TAT), fibrin degradation products (FDP), protein C activity (PC) level were compared between the two groups before and after treatment. The adverse reactions of the two groups were analyzed. Results After treatment, the total effective rate of the treatment group was 93.65%, significantly higher than that of the control group (80.95%) (P < 0.05). After treatment, NIHSS score at each time point of the two groups was significantly decreased compared with that before treatment (P < 0.05), and after treatment, NIHSS score at each time point of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, SSEQ and SS-QOL scores were significantly increased in both groups (P < 0.05), and it was more significantly in the treatment group (P < 0.05). After treatment, the plasma levels of PAP, TAT, FDP, and PC in two groups were significantly decreased (P < 0.05). After treatment, the plasma levels of PAP, TAT, FDP and PC in treatment group were significantly lower than those in control group (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group and the control group was 6.35% and 4.76%, respectively, and there was no statistical significance between the two groups. Conclusion Edaravone and Dexborneol Concentrated Solution for injection combined with agatroban has significant efficacy in treatment of acute cerebral infarction, and can safely and effectively improve the hypercoagulability of patients, inhibit thrombosis, and can play a good neuroprotective effect, which can improve patients’ self-efficacy and quality of life.

R971

北京京煤集團(tuán)總醫(yī)院院級(jí)科研基金項(xiàng)目（2019-12）