目的 探讨依达拉奉右莰醇注射用浓溶液联合阿加曲班治疗急性脑梗死的临床疗效。方法 选取2020年3月—2022年3月北京京煤集团总医院收治的126例急性脑梗死患者，按随机数字表法将所有患者分为对照组和治疗组，每组各63例。对照组使用阿加曲班注射液，开始2 d内以2.5 mg/h的速率持续静脉内泵入；随后5 d内调整为10 mg/次，2次/d，分别于早晚静脉滴注，每次给药时间为3 h。治疗组在对照组治疗基础上静脉滴注依达拉奉右莰醇注射用浓溶液，每次将15 mL加入生理盐水100 mL中充分稀释后30 min内滴完，2次/d。两组疗程为14 d。观察两组疗效，比较治疗前后两组相关量表[美国国立卫生研究院卒中量表（NIHSS）、脑卒中自我效能问卷（SSEQ）、脑卒中专门化生存质量量表（SS-QOL）]评分及血浆纤溶酶-抗纤溶酶复合物（PAP）、凝血酶抗凝血酶复合物（TAT）、纤维蛋白降解产物（FDP）、蛋白C活性（PC）水平。并统计两组不良反应情况。结果 治疗后，治疗组总有效率是93.65%，显著高于对照组的80.95%（P＜0.05）。治疗后，两组各时间点NIHSS评分均较治疗前显著降低（P＜0.05），且治疗后，治疗组各时间点NIHSS评分均显著低于对照组（P＜0.05）。治疗后，两组SSEQ、SS-QOL评分均显著增加（P＜0.05），且以治疗组增加更显著（P＜0.05）。治疗后两组血浆PAP、TAT、FDP、PC水平均显著下降（P＜0.05）；且治疗后，治疗组血浆PAP、TAT、FDP、PC水平均显著低于对照组（P＜0.05）。治疗过程中，治疗组和对照组不良反应发生率分别是6.35%、4.76%，两组比较差异没有统计学意义。结论 依达拉奉右莰醇注射用浓溶液联合阿加曲班治疗急性脑梗死可取得显著疗效，能安全有效地改善患者血液高凝状态，抑制血栓形成，并可发挥良好的神经保护作用，提高患者自我效能感和生活质量，值得临床推广应用。

Objective To investigate the clinical effect of Edaravone and Dexborneol Concentrated Solution for injection combined with agatroban in treatment of acute cerebral infarction. Methods A total of 126 patients with acute cerebral infarction admitted to Beijing Jingmei Group General Hospital from March 2020 to March 2022 were selected and divided into control group and treatment group according to random number table method, with 63 cases in each group. Patients in the control group were given Agattriban Injection, which was continuously pumped intravenously at a rate of 2.5 mg/h within 2 d. Then, the dosage was adjusted to 10 mg/time within 5 d, twice daily, and intravenous infusion was given in the morning and evening, and the administration time was 3 h each time. Patients in the treatment group were iv administered with Edaravone and Dexborneol Concentrated Solution for injection on the basis of the control group, and 15 mL was added into 100 mL normal saline for full dilution within 30 min, twice daily. The treatment course of the two groups was 14 d. After treatment, the clinical efficacy was evaluated, and the scores of the National Institutes of Health Stroke Scale (NIHSS), Stroke Self-Efficacy Questionnaire (SSEQ), Stroke Specialized Quality of Life Scale (SS-QOL), plasma plasminase-anti-plasminase complex (PAP), thrombin anti-thrombin complex (TAT), fibrin degradation products (FDP), protein C activity (PC) level were compared between the two groups before and after treatment. The adverse reactions of the two groups were analyzed. Results After treatment, the total effective rate of the treatment group was 93.65%, significantly higher than that of the control group (80.95%) (P < 0.05). After treatment, NIHSS score at each time point of the two groups was significantly decreased compared with that before treatment (P < 0.05), and after treatment, NIHSS score at each time point of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, SSEQ and SS-QOL scores were significantly increased in both groups (P < 0.05), and it was more significantly in the treatment group (P < 0.05). After treatment, the plasma levels of PAP, TAT, FDP, and PC in two groups were significantly decreased (P < 0.05). After treatment, the plasma levels of PAP, TAT, FDP and PC in treatment group were significantly lower than those in control group (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group and the control group was 6.35% and 4.76%, respectively, and there was no statistical significance between the two groups. Conclusion Edaravone and Dexborneol Concentrated Solution for injection combined with agatroban has significant efficacy in treatment of acute cerebral infarction, and can safely and effectively improve the hypercoagulability of patients, inhibit thrombosis, and can play a good neuroprotective effect, which can improve patients’ self-efficacy and quality of life.

R971

北京京煤集团总医院院级科研基金项目（2019-12）