目的 探討脈絡(luò)寧注射液聯(lián)合己酮可可堿注射液治療急性腦梗死的臨床療效。方法 選取2019年1月—2022年10月太和縣人民醫(yī)院收治的84例急性腦梗死患者，根據(jù)隨機(jī)數(shù)字表法將84例患者分為對(duì)照組和治療組，每組各42例。對(duì)照組靜脈滴注己酮可可堿注射液，于250 mL生理鹽水中加入0.1 g己酮可可堿注射液，最大滴速＜0.1 g/h，依據(jù)患者耐受性每次增加0.05 g，每次用藥量不超過0.2 g。治療組患者在對(duì)照組治療的基礎(chǔ)上靜脈滴注脈絡(luò)寧注射液，于250 mL 0.9%氯化鈉注射液中加入20 mL脈絡(luò)寧注射液，1次/d。兩組患者均連續(xù)治療10 d。觀察兩組的臨床療效，比較兩組治療前后神經(jīng)功能、凝血功能指標(biāo)、血清炎癥因子。結(jié)果 治療后，治療組總有效率95.24%高于對(duì)照組的總有效率80.95%，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組美國國立衛(wèi)生研究院卒中量表（NIHSS）評(píng)分下降（P＜0.05），且治療組NIHSS評(píng)分低于對(duì)照組（P＜0.05）。治療后，兩組纖維蛋白原（FIB）均下降，凝血酶時(shí)間（TT）、凝血酶原時(shí)間（PT）、活化部分凝血活酶時(shí)間（APTT）均升高（P＜0.05），且治療組FIB低于對(duì)照組，TT、PT、APTT均高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組血清白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、C反應(yīng)蛋白（CRP）水平均顯著下降（P＜0.05），且治療組血清IL-6、TNF-α、CRP水平均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。結(jié)論 脈絡(luò)寧注射液聯(lián)合己酮可可堿注射液治療急性腦梗死的效果顯著，可有效改善患者神經(jīng)功能和凝血功能、降低炎癥反應(yīng)。

Objective To explore the clinical effect of Mailuoning Injection combined with Pentoxifylline Injection in treatment of cerebral infarction. Methods Patients (84 cases) with cerebral infarction in Taihe County People’s Hospital from January 2019 to October 2022 were divided into control and treatment groups according to the random number table method, and each group had 42 cases. Patients in the control group were iv administered with Pentoxifylline Injection, 0.1 g added into normal saline 250 mL, drip rate of < 0.1 g/h, according to the patient’s tolerance, increasing the dosage by 0.05 g each time, and the dosage should not exceed 0.2 g each time. Patients in the treatment group were iv administered with Mailuoning Injection on the basis of the control group, 20 mL added into 0.9% sodium chloride injection, once daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and the nerve function, coagulation function index, serum inflammatory factor in two groups were compared. Results After treatment, the total effective rate of 95.24% in the treatment group was higher than 80.95% in the control group, with a statistically significant difference (P < 0.05). After treatment, NIHSS scores of two groups were decreased (P < 0.05), and NIHSS scores of the treatment group were lower than those of the control group (P < 0.05). After treatment, FIB in two groups were decreased, but TT, PT, and APTT in two groups were increased (P < 0.05). FIB in the treatment group was lower than that in the control group, while TT, PT, and APTT were higher than those in the control group, with a statistically significant difference (P < 0.05). After treatment, the serum levels of IL-6, TNF-α, and CRP in two groups were significantly decreased (P < 0.05), and the serum levels of IL-6, TNF-α, and CRP in the treatment group were lower than those in the control group, with statistical significance (P < 0.05). Conclusion Mailuoning Injection combined with Pentoxifylline Injection has a significant effect in treatment of cerebral infarction, can effectively improve the neurological function and coagulation function of patients, reduce inflammatory response.

R971

阜陽市自籌類科技計(jì)劃項(xiàng)目(FK202081085)