目的 探讨灯盏花素注射液联合曲克芦丁治疗急性脑梗死患者的临床疗效。方法 选取2019年1月—2020年3月在天津市泰达医院诊治的120例急性脑梗死患者为研究对象，随机分为对照组和治疗组，每组各60例。对照组患者静脉滴注注射用曲克芦丁，0.48 g加入5%葡萄糖注射液250 mL，1次/d；治疗组患者在对照组基础上静脉滴注灯盏花素注射液，20 mg加入生理盐水250 mL中，1次/d。两组患者均治疗2周。观察两组患者临床疗效，同时比较治疗前后两组患者神经功能缺损评分、日常生活活动能力评分、缺血半暗带体积及血栓素A2（TXA2）、前列腺素（PGI2）、TXA2/PGI2、过氧化氢酶（CAT）、谷胱甘肽过氧化物酶（GSH-Px）、过氧化脂质（LPO）、S100钙结合蛋白β（S100β）和胶质纤维酸性蛋白（GFAP）水平。结果 治疗后，对照组临床有效率为85.00%，显著低于治疗组的96.67%（P<0.05）。治疗后，两组患者NIHSS评分显著降低，FIM评分较治疗前均显著提高（P<0.05），且治疗组患者NIHSS评分、FIM评分改善更明显，差异有统计学意义（P<0.05）。治疗后，两组患者缺血半暗带体积较治疗前显著降低（P<0.05），且治疗组缺血半暗带体积降低的更明显（P<0.05）。治疗后，两组患者TXA2、TXA2/PGI2、LPO、S100β、GFAP水平较治疗前均显著降低，PGI2、CAT、GSH-Px水平较治疗前均显著升高（P<0.05），且治疗组患者上述指标改善更明显，两组比较差异有统计学意义（P<0.05）。结论 灯盏花素注射液联合曲克芦丁可显著改善急性脑梗死患者的神经功能，有效抑制氧化应激反应，临床疗效佳，且安全性高，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Dengzhanhuasu Injection combined with troxerutin in treatment of acute cerebral infarction. Methods Patients (120 cases) with acute cerebral infarction in Tianjin TEDA Hospital from January 2019 to March 2020 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were iv administered with Troxerutin for injection, 0.48 g added into 5% glucose injection 250 mL, once daily. Patients in the treatment group were iv administered with Dengzhanhuasu Injection on the basis of the control group, 20 mg added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the neurological deficit score, activity of daily living score, ischemic penumbra volume, and the levels of TXA2, TXA2/PGI2, PGI2, CAT, GSH-Px, LPO, S100β and GFAP in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 85.00%, which was significantly lower than 96.67% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the NIHSS score in two groups was significantly decreased, and the FIM score was significantly increased compared with before treatment (P<0.05), and the NIHSS score and FIM score in the treatment group were improved more obviously, the difference was statistically significant (P<0.05). After treatment, the volume of ischemic penumbra in two groups was significantly decreased compared with that before treatment (P<0.05), and the volume of ischemic penumbra in the treatment group was more significantly decreased (P<0.05). After treatment, the levels of TXA2, TXA2/PGI2, LPO, S100β and GFAP in two groups were significantly decreased compared with before treatment, while the levels of PGI2, CAT and GSH-Px were significantly increased compared with before treatment (P<0.05), and the improvement of above indexes in the treatment group was more obvious. The difference between the two groups was statistically significant (P<0.05). Conclusion Dengzhanhuasu Injection combined with troxerutin can significantly improve the neurological function in treatment of acute cerebral infarction, effectively inhibit oxidative stress reaction, with better clinical efficacy and higher safety, which has a certain clinical application value.

R971