目的 通過傾向評分匹配法（PSM）評價己酮可可堿注射液治療輕中度急性缺血性腦卒中患者的有效性和安全性。方法 納入合肥市第一人民醫(yī)院神經(jīng)內(nèi)科2023年10月—2024年3月急性腦卒中住院患者，所有患者按照此次住院期間有無使用己酮可可堿注射液分為治療組和對照組，選擇年齡、性別、住院天數(shù)、創(chuàng)傷侵入性操作、使用抗菌藥物和使用精神藥物共6個因素作為協(xié)變量，運用PSM法對兩組1∶1匹配，收集匹配后兩組患者美國國立衛(wèi)生研究院卒中量表（NIHSS）、改良Rankin量表（MRS）、日常生活活動（ADL）評分結(jié)果和藥物不良反應(yīng)記錄，計算兩組治療前后評分指標(biāo)變化、治療有效率和不良反應(yīng)發(fā)生率。結(jié)果 匹配前共納入患者348例，藥物組∶對照組=81∶267，兩組間住院日、創(chuàng)傷侵入性操作和使用抗菌藥物等3個因素存在顯著性差異（P<0.05）；采用PSM法平衡兩組間混雜因素，兩組匹配后均為70例，組間基線差異無顯著性（P>0.05）；藥物治療后，對照組NIHSS、MRS評分較治療前有顯著改善（P<0.05）,ADL評分治療前后變化無統(tǒng)計學(xué)意義（P>0.05），己酮可可堿組治療后以上3個指標(biāo)較治療前均有明顯改善，差異有統(tǒng)計學(xué)意義（P<0.05）；己酮可可堿治療組治療后NIHSS、MRS和ADL評分結(jié)果變化均優(yōu)于對照組（P>0.05）；匹配后兩組治療總有效率分別為98.58%（治療組）和92.86%（對照組），兩組不良反應(yīng)發(fā)生率分別為2.86%（治療組）和1.43%（對照組）；兩組匹配后總有效率和不良反應(yīng)發(fā)生率差異均無統(tǒng)計學(xué)意義（P>0.05）。結(jié)論 PSM法適用于本研究，己酮可可堿治療輕中度缺血性腦卒中患者安全有效，其相關(guān)評分指標(biāo)優(yōu)于對照組，但總體治療有效率和對照組無顯著性差異。

Objective To evaluate the effectiveness and safety of Pentoxifylline Injection in the treatment of mild to moderate acute ischemic stroke patients using propensity score matching method. Methods Patients with acute stroke admitted to the neurology department of the First People’s Hospital of Hefei from October 2023 to March 2024 were included. All patients were divided into a treatment group and a control group based on whether they used Ketoconazole Injection during their hospitalization. Six covariates, including age, gender, length of hospital stay, invasive procedures, use of antibiotics and use of psychotropic drugs were selected. The propensity score method was used to match the two groups in 1:1 ratio. The NIHSS score, MRS score, ADL score results and adverse drug reaction records of the matched patients were collected;then the changes in scoring indicators, treatment efficacy and incidence of adverse reactions before and after treatment were calculated for both groups. Result A total of 348 patients were enrolled before matching, with a drug group to control group ratio of 81:267. There were significant differences between the two groups in terms of length of hospital stay, invasive procedures and use of antibiotics（P＜0.05）. The propensity score method was used to balance the confounding factors between the two groups. After matching, there were 70 cases in both groups, and there was no significant difference in baseline between the groups（P＞0.05）; After drug treatment, the control group showed significant improvement in NIHSS score and MRS score compared to before treatment（P＜0.05）, while there was no statistically significant change in ADL score before and after treatment（P＞0.05）. The treatment group showed significant improvement in all three indicators after treatment compared to before treatment, with statistically significant differences（P＜0.05）; The changes in NIHSS score, MRS score, and ADL score in the treatment group were better than those in the control group after treatment（P＞0.05）; After matching, the total effective rates of the two treatment groups were 98.58%（treatment group） and 92.86%（control group）, respectively. The incidence of adverse reactions in the two groups was 2.86%（treatment group） and 1.43%（control group）, respectively; There was no statistically significant difference in the total effective rate and incidence of adverse reactions between the two groups after matching（P＞0.05）. Conclusion The propensity score matching method was applicable to this study. Pentoxifylline Injection was safe and effective in treating patients with mild to moderate ischemic stroke, and its related scoring indicators were better than those of the control group. However, there was no significant difference in overall treatment efficacy between the two groups.

R971

2024-2025年度安徽省中醫(yī)藥傳承創(chuàng)新科研項目(2024CCCX234)