目的 探讨注射用红花黄色素联合阿加曲班治疗急性脑梗死的临床疗效。方法 选取2014年9月—2015年9月西安医学院第二附属医院收治的急性脑梗死患者96例,依据不同治疗方案分为治疗组和对照组,每组各48例。所有患者均给予降低颅内压、营养神经、调节血脂等基础治疗。对照组在此基础上给予阿加曲班注射液,第1~2天,阿加曲班注射液60 mg加入生理盐水500 mL,24 h持续泵入;其后5 d,阿加曲班注射液10 mg加入生理盐水100 mL,3 h持续泵入,2次/d,第8~14天,1次/d。治疗组在对照组的基础上滴注注射用红花黄色素,100 mL/次,1次/d。两组均连续治疗2周。观察两组临床疗效,同时比较两组神经功能缺损量表(NIHSS)评分、Barthel指数、血液流变学指标和血管内皮功能及炎症因子变化情况。结果 治疗后,对照组和治疗组总有效率分别为77.08%、91.67%,两组比较差异有统计学意义(P<0.05)。治疗后,两组血浆黏度、全血黏度、红细胞压积(HCT)以及红细胞聚集指数(RF)均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组这些观察指标显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组NIHSS评分均降低,Barthel指数均升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗2周后治疗组这些观察指标显著好于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组一氧化氮(NO)、内皮素-1(ET-1)、白细胞介素-8(IL-8)和肿瘤坏死因子α(TNF-α)表达水平均较治疗前明显改善,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗2周后治疗组这些观察指标显著好于对照组,两组比较差异具有统计学意义(P<0.05)。结论 注射用红花黄色素联合阿加曲班治疗急性脑梗死具有较好的临床疗效,能明显改善患者的血液流变学指标和血管内皮功能,具有一定的临床推广应用价值。

Objective To investigate clinical efficacy of Safflower Yellow for injection combined with argatroban in treatment of acute cerebral infarction. Methods Patients (96 cases) with acute cerebral infarction in Second Affiliated Hospital of Xi'an Medical University from September 2014 to September 2015 were divided into control and treatment groups based on different treatment method, and each group had 48 cases. All patients were treated with conventional treatments including reducing intracranial pressure, trophic nerve, and regulating blood fat. Patients in control group were administered with Argatroban Injection on the basis of conventional treatment, 60 mg added into normal saline 500 mL and through 24 h continuous iv pump infusion in first and second day; the next five days they were treated with Argatroban Injection, 10 mg added into normal saline 100 mL and through 3 h continuous iv pump infusion twice daily, and 8th to 14th day once daily. The patients in the treatment group were iv administered with Safflower Yellow for injection on the basis of the control group, 100 mL/time, once daily. The patients in two groups were treated for two weeks. After treatment, the efficacy was evaluated, and the changes of NIHSS scores, Barthel indexes, vascular endothelial function, and inflammatory factors in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.08% and 91.67%, respectively, and there were differences between two groups (P< 0.05). After treatment, plasma viscosity, whole blood viscosity, hematocrits (HCT), and erythrocyte aggregation index (RF) in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). And the observational index in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). After treatment, NIHSS scores were significant decreased, Barthel indexes were significant increased, and the difference was statistically significant in the same group (P< 0.05). And after treatment for two weeks, the observational index in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). After treatment, nitric oxide (NO), endothelin-1 (ET-1), interleukin-8 (IL-8), and tumor necrosis factor α (TNF-α) were significantly improved, and the difference was statistically significant in the same group (P< 0.05). And after treatment for two weeks, the observational index in the treatment group was better than that in the control group, with significant difference between two groups (P< 0.05). Conclusion Safflower yellow for injection combined with argatroban has clinical curative effect in treatment of acute cerebral infarction, and significantly improve hemorheology and vascular endothelial function, which has a certain clinical application value.