目的 探討復(fù)方腦肽節(jié)苷脂聯(lián)合奧扎格雷鈉治療急性進(jìn)展性腦梗死的臨床療效。方法 選取2021年8月—2023年11月佳木斯市中心醫(yī)院收治的104例急性進(jìn)展性腦梗死患者，按隨機(jī)數(shù)字表法將患者分為對照組和治療組，每組各52例。對照組靜脈滴注注射用奧扎格雷鈉，80 mg/次，于0.9%氯化鈉注射250 mL中充分溶解，2次/d。治療組在對照組基礎(chǔ)上靜脈滴注復(fù)方腦肽節(jié)苷脂注射液，10 mg/次，于0.9%氯化鈉注射250 mL中充分稀釋，1次/d。兩組療程均為14 d。觀察兩組臨床療效，比較兩組治療前后美國國立衛(wèi)生研究院卒中量表（NIHSS）評分、患側(cè)大腦中動脈（MCA）血流動力學(xué)指標(biāo)和血清髓鞘堿性蛋白（MBP）、基質(zhì)金屬蛋白酶-9（MMP-9）、高遷移率族蛋白B1（HMGB1）、堿性成纖維細(xì)胞生長因子（bFGF）水平。結(jié)果 治療后，治療組總有效率是90.38%，顯著高于對照組的75.00%（P＜0.05）。治療7、14 d后，治療組NIHSS評分均較治療前顯著降低，對照組在治療14 d后NIHSS評分明顯降低（P＜0.05）；且治療7、14 d后，治療組NIHSS評分均顯著低于同期對照組（P＜0.05）。治療后，兩組患側(cè)MCA收縮期峰值血流速度（Vs）、舒張末期血流速度（Vd）、平均血流速度（Vm）均較同組治療前顯著升高（P＜0.05）；治療后，治療組腦血流動力學(xué)指標(biāo)高于對照組（P＜0.05）。治療后，兩組血清MBP、MMP-9、bFGF、HMGB1水平顯著降低（P＜0.05）；治療后，治療組血清MBP、MMP-9、bFGF、HMGB1水平低于對照組（P＜0.05）。結(jié)論 復(fù)方腦肽節(jié)苷脂聯(lián)合奧扎格雷鈉治療急性進(jìn)展性腦梗死具有較好的療效，能在良好安全性的基礎(chǔ)上有效促進(jìn)神經(jīng)功能恢復(fù)及炎癥反應(yīng)緩解，改善腦血流動力學(xué)，提高臨床療效。

Objective To explore the clinical efficacy of compound porcine cerebroside and ganglioside combined with ozagrel sodium in treatment of acute progressive cerebral infarction. Methods A total of 104 patients with acute progressive cerebral infarction admitted to Jiamusi Central Hospital from August 2021 to November 2023 were selected and divided into control group and treatment group according to random number table method, with 52 cases in each group. Patients in control group were iv administered with Ozagrel Sodium for injection, 80 mg/time, fully dissolved in 250 mL injection of 0.9% sodium chloride, twice daily. Patients in treatment group were iv administered with Compound Porcine Cerebroside and Ganglioside Injection on the basis of the control group, 10 mg/ time, fully diluted in 250 mL injection of 0.9% sodium chloride, once daily. The treatment course of both groups was 14 d. The clinical efficacy of the two groups was observed, and the changes of National Institutes of Health Stroke Scale (NIHSS) score, affected middle cerebral artery (MCA) hemodynamic indexes, serum myelin basic protein (MBP), matrix metalloproteinase-9 (MMP-9), high mobility group protein B1 (HMGB1), basic fibroblast growth factor (bFGF) levels before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 90.38%, which was significantly higher than that of the control group (75.00%, P < 0.05). After 7 and 14 d of treatment, the NIHSS score of the treatment group was significantly lower than that before treatment, and the NIHSS score of the control group was significantly lower after 14 d of treatment ( P < 0.05). After 7 and 14 d of treatment, NIHSS scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, MCA peak systolic blood flow velocity (Vs), end-diastolic blood flow velocity (Vd) and mean blood flow velocity (Vm) were significantly increased in both groups compared with before treatment (P < 0.05). After treatment, the cerebral hemodynamic indexes in the treatment group were higher than those in the control group (P < 0.05). After treatment, serum levels of MBP, MMP-9, bFGF and HMGB1 in two groups were significantly decreased (P < 0.05). After treatment, serum levels of MBP, MMP-9, bFGF and HMGB1 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Compound porcine cerebroside and ganglioside combined with ozagrel sodium has a good effect in treatment of acute progressive cerebral infarction, can effectively promote the recovery of nerve function and relieve inflammation on the basis of good safety, which can improve cerebral hemodynamics and clinical efficacy.

R971