目的 探讨灯盏花素注射液联合阿加曲班治疗急性脑梗死的临床效果。方法 选取2020年1月—2021年3月天津医科大学宝坻临床学院收治的90例急性脑梗死患者，随机分成对照组和治疗组，每组各45例。对照组静脉滴注阿加曲班注射液，前2 d以60 mg/d的剂量静脉泵入24 h，第3天以10 mg/次滴注，2次/d，1次/12 h，给药时间3 h/次，连续治疗5 d。治疗组在对照组基础上静脉滴注灯盏花素注射液，20 mg加入250 mL 10%葡萄糖注射液，1次/d。两组患者连续治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生研究院卒中量表（NIHSS）评分、血小板最大聚集率（MAR），血浆纤维蛋白原（FIB）和D-二聚体（D-D）水平，及血清金属基质蛋白酶-9（MMP-9）、内皮素-1（ET-1）、单核细胞趋化蛋白-1（MCP-1）和白细胞介素-1β（IL-1β）水平。结果 治疗后，治疗组患者总有效率为91.1%，明显高于对照组的75.6%（P<0.05）。治疗后，两组NIHSS评分均逐渐降低（P<0.05）。治疗3、7、14 d后，治疗组NIHSS评分显著低于同期对照组（P<0.05）。治疗后，两组MAR和血浆FIB、D-D均显著降低（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗后，两组血清MMP-9、ET-1、MCP-1和IL-1β水平均显著下降（P<0.05），且治疗组降低更明显（P<0.05）。结论 灯盏花素注射液联合阿加曲班治疗急性脑梗死的整体疗效确切，可有效减轻患者神经功能缺损。

Objective To investigate the clinical effect of Dengzhanhuasu Injection combined with argatroban in treatment of acute cerebral infarction. Methods Patients (90 cases) with acute cerebral infarction in Baodi Clinical Medical College of Tianjin Medical University from January 2020 to March 2021 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were iv administered with Argatroban Injection, intravenously pumped with 60 mg/d for 24 h in the first 2 days, 10 mg/time for 3 h in the 3rd day, once every 12 h, they were treated for 5 d. Patients in the treatment group were iv administered with Dengzhanhuasu Injection on the basis of the control group, 20 mg added into 10% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, the NIHSS, MAR, the concentrations of plasma FIB and D-D, and the levels of serum MMP-9, ET-1, MCP-1, and IL-1β in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 91.1%, which was significantly higher than 75.6% in the control group (P < 0.05). After treatment, NIHSS scores in both groups decreased gradually (P < 0.05). After 3, 7, and 14 days of treatment, the NIHSS score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, MAR, plasma FIB and D-D concentrations in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of serum MMP-9, ET-1, MCP-1, and IL-1β in two groups were significantly decreased (P < 0.05), and the decrease was more obvious in the treatment group (P < 0.05). Conclusion Dengzhanhuasu Injection combined with argatroban is effective in treatment of acute cerebral infarction and can effectively reduce the neurological deficit of patients.

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