目的 观察复方血栓通胶囊联合注射用阿替普酶治疗急性脑梗死的临床疗效。方法 选取2018年6月—2020年6月天津市北辰医院接收89例急性脑梗死患者，按照门诊单双号将所有患者分为对照组（45例）和治疗组（44例）。对照组给予注射用阿替普酶，剂量按0.9 mg/kg计算，最大剂量<90 mg，首先于1 min内静脉推注药量10%，其余90%在0.9%氯化钠溶液100 mL稀释后于1 h内静脉滴注完毕。治疗组于对照组基础上口服复方血栓通胶囊，3粒/次，3次/d，连续治疗10 d。两组治疗10 d后进行疗效比较。观察两组治疗效果，比较两组血清学指标和生活能力。结果 治疗后，治疗组的总有效率（97.73%）较对照组的总有效率（82.22%）高，组间比较差异有统计学意义（P<0.05）。治疗后，两组神经元特异性烯醇化酶（NSE）、超敏C反应蛋白（hs-CRP）、可溶性细胞间黏附分子-1（sICAM-1）水平均较治疗前下降（P<0.05），且治疗组NSE、hs-CRP、sICAM-1水平低于对照组（P<0.05）。随访90 d后，两组改良RanKin量表（mRS）评分均较治疗前降低（P<0.05），治疗组mRS评分低于对照组（P<0.05）。结论 复方血栓通胶囊联合注射用阿替普酶治疗急性脑梗死的疗效确切，可降低患者血清NSE、hs-CRP、sICAM-1水平，提高其生活能力，促进预后，且不增加用药安全性风险。

Objective To observe the effect of Compound Xueshuantong Capsules combined with Alteplase for injection in treatment of acute cerebral infarction.Methods Patients (89 cases) with acute cerebral infarction in Tianjin Beichen Hospital from June 2018 to June 2020 were randomly divided into the control group (45 cases) and the treatment group (44 cases). Patients in the control group were given Alteplase for injection, 0.9 mg/kg, maximum dose<90 mg, first, 10% of the drug was injected intravenously within 1 min, and the remaining 90% was diluted with 100 mL 0.9% sodium chloride solution, and then intravenous drip was completed within 1 h. Patients in the treatment group were po administered with Compound Xueshuantong Capsules on the basis of the control group, 0.3 grains/time, three times daily, treated for 10 d. After treatment for 10 d, the clinical efficacies were evaluated, and serological indicators and living ability in two groups were compared.Results After treatment, the total effective rate of the treatment group (97.73%) was higher than that of the control group (82.22%), and the difference was statistically significant (P<0.05). After treatment, the levels of NSE, hs-CRP, and sICAM-1 in two groups were lower than those before treatment (P<0.05), and the levels of NSE, hs-CRP, and sICAM-1 in the treatment group were lower than those in the control group (P<0.05). After 90 d of follow-up, the mRS scores of two groups were lower than those before treatment (P<0.05), and the mRS scores of the treatment group were lower than those of the control group (P<0.05).Conclusion Compound Xueshuantong Capsules combined with Alteplase for injection has certain efficacy in the treatment of acute cerebral infarction, can reduce the serum levels of NSE, hs-CRP, and sICAM-1 of patients, improve their living ability, promote the prognosis, without increasing the risk of medication safety.

R971

天津市北辰区科技计划项目（SHGY-2020033）