目的 探讨杜蛭丸联合尤瑞克林治疗老年急性脑梗死的临床疗效。方法 以2019年2月-2020年2月在郑州大学第五附属医院进行治疗的94例急性脑梗死患者为研究对象，根据用药的差别分为对照组（47例）和治疗组（47例）。对照组给予注射用尤瑞克林，0.15 PNA单位/次，同100 mL生理盐水配伍，1次/d，30 min内静脉滴注完毕；治疗组在对照组基础上口服杜蛭丸，5 g/次，2次/d。两组均治疗2周后进行效果比较。观察两组的临床疗效，比较两组治疗前后相关评分、血清学因子、血管内皮功能指标的变化情况。结果 经治疗，对照组总有效率为80.85%，显著低于治疗组（97.87%，P<0.05）。治疗后，两组美国国立卫生研究院卒中量表（NIHSS）评分显著降低，但功能独立性评定（FIM）评分、蒙特利尔认知（MoCA）评分、简明精神状态量表（MMSE）评分均显著提高（P<0.05），且治疗后，治疗组患者NIHSS评分显著低于对照组，而FIM评分、MoCA评分、MMSE评分高于对照组（P<0.05）。治疗后，两组血清同型半胱氨酸（Hcy）、可溶性血管细胞黏附分子（sVCAM-1）、半乳糖凝集素3（Gal-3）、趋化因子CXCL12（CXCL12）、神经元特异性烯醇化酶（NSE）、胶质纤维酸性蛋白（GFAP）水平均显著降低（P<0.05）；治疗后，治疗组血清学指标显著低于对照组（P<0.05）。治疗后，两组血清血管性血友病因子（vWF）、内皮素-1（ET-1）显著降低，但内皮细胞一氧化氮合酶（eNOS）水平均显著升高（P<0.05）；治疗后，治疗组血清vWF、ET-1水平低于对照组，而eNOS水平高于对照组（P<0.05）。结论 杜蛭丸联合尤瑞克林治疗老年急性脑梗死效果良好，可促进患者神经功能恢复，提高患者认知能力和生活质量，可有效改善机体血清因子水平，具有一定的临床推广应用价值。

Objective To explore the clinical effect of Duzhi Pills combined with urinary kallidinogenase in treatment of senium acute cerebral infarction. Methods A total of 94 patients with acute cerebral infarction treated in the Fifth Affiliated Hospital of Zhengzhou University from February 2019 to February 2020 were studied. According to the difference of drug usage, patients were divided into control group (47 cases) and treatment group (47 cases). Patients in the control group were given Urinary Kallidinogenase for injection, 0.15 PNA unit/time, compatible with 100 mL normal saline, once daily, and intravenous infusion was completed within 30 min. Patients in the treatment group were po administered with Duzhi Pills on the basis of the control group, 5 g/time, twice daily. The two groups were compared after 2 weeks of treatment. The clinical efficacy of the two groups was observed, and the changes of relevant scores, serological factors and vascular endothelial function indexes before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the control group was 80.85%, significantly lower than that of the treatment group (97.87%, P<0.05). After treatment, NIHSS scores of the two groups were significantly reduced, but the FIM scores,Montreal Cognition (MoCA) scores and MMSE scores of the two groups were significantly increased (P<0.05). Moreover, the NIHSS score of the treatment group was significantly lower than that of the control group, while the FIM scores, MoCA scores and MMSE scores of the treatment group were significantly higher than those of the control group (P<0.05). After treatment, the serum levels of Hcy, SVCAM-1, Gal-3, CXCL12, NSE, and GFAP in the two groups were significantly decreased (P<0.05). After treatment, the serological indexes of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, vWF and ET-1 were significantly decreased in both groups, but the levels of eNOS in endothelial cells were significantly increased in both groups (P<0.05). After treatment, the serum levels of vWF and ET-1 in the treatment group were lower than those in the control group, and the levels of eNOS were higher than those in the control group (P<0.05). Conclusion Duzhi Pills combined with urinary kallidinogenase has good therapeutic effect in treatment of senium acute cerebral infarction, and can promote patients' neurological function recovery, improve patients' cognitive ability and life quality, and effectively improve the serum factors, which has certain clinical popularization and application value.

R971

河南省医学科技攻关计划联合共建项目（LHGJ20190412）