目的 观察血栓通联合阿司匹林治疗急性脑梗死的临床疗效及其安全性，为指导临床合理用药提供理论参考。方法 选取2011年12月-2013年12月青海省人民医院收治的急性脑梗死患者68例，随机分为对照组和治疗组，每组34例，两组治疗期间均给予常规治疗，对照组给予阿司匹林肠溶片100 mg/次，1次/d。治疗组在对照组基础上静脉输注注射用血栓通（冻干）500 mg加入0.9%氯化钠注射液250 mL，1次/d。两组均连续治疗14 d。观察两组的临床疗效，同时观察两组组织纤溶酶原激活物（t-PA）、血栓调节蛋白（TM）、组织纤溶酶原激活物抑制物（PAI）、D-二聚体（D-dimer）及血液流变学指标变化。结果 治疗后，治疗组和对照组的总有效率分别为94.12%、91.18%，两组比较差异有统计学意义（P<0.05）。治疗后，两组的t-PA水平较治疗前上升，TM、PAI、D-dimer水平均较治疗前降低，同组治疗前后差异有统计学意义（P<0.05、0.01）。治疗组经治疗后，t-PA、TM、PAI的改善程度均优于对照组，两组比较差异有统计学意义（P<0.05、0.01）。治疗后，两组各项血流动力学指标均有不同程度的降低，同组治疗前后比较差异均有统计学意义（P<0.05、0.01）。治疗后，治疗组红细胞压积、全血高切黏度、全血低切黏度、血浆高切黏度、纤维蛋白原均比对照组降低更加明显，两组比较差异有统计学意义（P<0.05）。结论 在常规治疗的基础上，给予血栓通治疗急性脑梗死能显著改善患者的神经功能和血液流变学效应，提高患者的生活质量，且未见明显的不良反应，值得临床推广应用。

Objective To observe the clinical efficacy and safety of Xueshuantong combined with aspirinon in treatment of acute cerebral infarction and to provide some knowledge for the rational use of drugs. Methods Acute cerebral infarction patients (68 cases) of Qinghai provincial people's Hospital from December 2011 to December 2013 were randomly divided into treatment and control groups, 34 cases in each group. The patients in both groups received conventional therapy. Patients in the control group were given aspirin enteric-coated metformin hydrochloride (100 mg/d). Patients in the treatment group were iv injected with Xueshuantong (lyophilization) 500 mg adding 0.9% Sodium Chloride Injection (250 mL) on the basis of the control group, once daily. All the patients were treated continuously for 14 d. The total clinical efficacy was observed, including the changes of t-PA, TM, PAI, D-dimer, and hemorheology in acute cerebral infarction patients. Results The total effective rates of treatment and control groups were 94.12% and 91.18%, respectively, with significant difference between two groups (P < 0.05). After treatment, the level of t-PA was higher, TM, PAI, and D-dimer were lower compared with those before treatment in the two groups, and the differences was statically significant in the same group before and after treatment (P < 0.05, 0.01). After treatment, the improvement degree of t-PA, TM, and PAI in the treatment group were better than those in the control group, with significant difference between the two groups (P < 0.05, 0.01). After treatment, all the hemorrheology indexes in two groups were obviously lower, and the differences was statically significant in the same group before and after treatment (P < 0.05, 0.01). After treatment, the blood hematocrit, high shear viscosity, low sheer viscosity, plasma hyperviscosity and fibrinogen were lower than those in the control group. There was significant difference between the two groups (P < 0.05). Conclusion The therapy of Xueshuantong for acute cerebral infarction on the basis of conventional treatment can significantly improve the neurological function and blood rheology effect, while can improve the life quality of patients without adverse reaction, which is worthy of clinical application. reaction, which is worthy of clinical application.