目的 探讨醒脑静注射液联合纤溶酶治疗急性脑梗死的临床疗效。方法 选取2012年7月—2015年1月重庆市巴南区第二人民医院收治的急性脑梗死患者200例,随机分为对照组和治疗组,每组各100例。对照组在常规治疗的基础上静脉滴注注射用纤溶酶,100 U加入到5%葡萄糖注射液250 mL中,1次/d。治疗组在对照组的基础上速度静脉滴注醒脑静注射液,20 mL/次,1次/d。两组患者均治疗12周。比较两组的临床疗效、神经功能缺损量表(NIHSS)以及日常生活活动能力量表(ADL)评分、血液流变学指标全血高切黏度(HBV)、全血低切黏度(LBV)、红细胞压积(HCT)、血浆黏度(SV)、纤维蛋白原(FIB)含量、血沉(ESR)以及血小板聚集率(PAR)的变化。结果 治疗后,轻、中重度急性脑梗死患者治疗组的总有效率均显著高于对照组(P<0.05),且轻度患者的总有效率显著高于中重度患者同组的总有效率(P<0.05)。轻、中重度急性脑梗死患者治疗后的NIHSS、ADL评分均较同组治疗前显著改善,差异具有统计学意义(P<0.05);治疗组的NIHSS评分降低程度更为明显,比较差异具有显著性(P<0.05);治疗后,轻、中重度急性脑梗死患者治疗组的NIHSS、ADL评分均较同程度患者对照组显著改善,差异具有统计学意义(P<0.05)。轻、中重度急性脑梗死患者治疗组的NIHSS、ADL评分均较同程度患者对照组显著改善,差异具有统计学意义(P<0.05)。治疗后,两组的HBV、LBV、HCT、FIB、SV、PAR均较同组治疗前显著改善,差异具有统计学意义(P<0.05);治疗组治疗后的HBV、HCT、FIB、SV、ESR、PAR均较对照组治疗后显著改善,差异具有统计学意义(P<0.05)。结论 醒脑静注射液联合纤溶酶治疗急性脑梗死具有较好的临床疗效,可改善患者的神经功能和生活质量,能够显著改善血液流动性指标,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Xingnaojing Injection combined with fibrinolysin in treatment of acute cerebral infarction. Methods Patients (200 cases) with acute cerebral infarction in Chongqing Banan District Second People's Hospital from July 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 100 cases. The patients in the control group were iv administered with Fibrinogenase for injection on the basis of conventional treatment, 100 U Fibrinogenase for injection added into 5% Glucose Injection 250 mL, once daily. The patients in the treatment group were iv administered with Xingnaojing Injection on the basis of the control group, 20 mL/time, once daily. The patients in two groups were treated for 12 weeks. After treatment, the efficacy was evaluated, and the changes of NIHSS scores, ADL scores, hemodynamic indexes high blood viscosity (HBV), low blood viscosity (LBV), hematocrit (HCT), plasma viscosity (SV), fibrinogen (FIB), blood sedimentation (ESR), and platelet aggregation rate (PAR) in two groups before and after treatment were compared. Results The clinical efficacy of patients with mild and moderately severe acute cerebral infarction in treatment group was higher than that in control group with significant difference (P < 0.05). And the efficacy of patients with mild acute cerebral infarction was higher than that of patients with moderately severe acute cerebral infarction in same group with significant difference (P < 0.05). After treatment, NIHSS and ADL scores of patients with mild and moderately severe acute cerebral infarction were improved compared with those of same group before treatment, and there were significant difference (P < 0.05). After treatment, NIHSS and ADL scores of patients with mild and moderately severe acute cerebral infarction in treatment group were improved more than those in control group with significant difference (P < 0.05). HBV, LBV, HCT, FIB, SV, and PAR of two groups were improved more than those in same group after treatment with significant difference (P < 0.05). HBV, HCT, FIB, SV, ESR, and PAR in treatment group were improved more than those in control group after treatment with significant difference (P < 0.05). Conclusion Xingnaojing Injection combined with fibrinolysin has clinical curative effect in treatment of acute cerebral infarction, and can improve nerve function and quality of life, significantly improve hemodynamic indexes, which has a certain clinical application value.