目的 比较前列地尔与法舒地尔治疗急性脑梗死的临床疗效。方法 选取2013年1月-2015年7月榆林市第一医院收治的急性脑梗死患者92例，随机分为对照组（44例）和治疗组（48例）。对照组静脉滴注盐酸法舒地尔注射液，60 mg加入到生理盐水250 mL中，1次/d。治疗组静脉滴注前列地尔注射液，20 μg加入到生理盐水250 mL中，1次/d。两组患者均连续治疗2周。观察两组的临床疗效，比较两组NISS评分、正五聚体蛋白3（PTX-3）及颈动脉粥样斑块的变化。结果 治疗后，对照组和治疗组的总有效率分别为77.3%、93.8%，两组比较差异有统计学意义（P<0.05）。治疗后，两组NISS评分均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组NISS评分的下降程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组PTX-3均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组PTX-3的下降程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组斑块形成率显著下降，而稳定斑块比例上升，治疗组同组治疗前后比较差异有统计学意义（P<0.05）。对照组和治疗组斑块形成率分别为35.4%、56.8%，稳定斑块所占比例分别为52.0%、94.1%，两组比较差异具有统计学意义（P<0.05）。结论 前列地尔治疗急性脑梗死具有较好的临床疗效，可改善临床症状，降低PTX-3，提高斑块稳定性，安全性较好，具有一定的临床推广应用价值。

Objective To compare clinical curative effect of alprostadil and fasudil in treatment of acute cerebral infarction. Methods Patients (92 cases) with acute cerebral infarction in the First Hospital of Yulin City from January 2013 to July 2015 were randomly divided into control group (44 cases) and treatment group (48 cases). Patients in the control group were iv administered with Fasudil Hydrochloride Injection, 60 mg added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Alprostadil Injection, 20 μg added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and the changes of NISS scores, PTX-3, and carotid atherosclerotic plaque in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.3% and 93.8%, respectively, and there was difference between two groups (P<0.05). After treatment, the NISS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the NISS score in the treatment group were significantly lower than that in the control group, with significant difference between two groups (P<0.05). After treatment, the PTX-3 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the PTX-3 in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P<0.05). After treatment, the plaque formation rate in the control and treatment groups were 35.4% and 56.8%, respectively, and the proportion of stable plaques were 52.0% and 94.1%, respectively, and there was difference between two groups (P<0.05). Conclusion Alprostadil has clinical curative effect in treatment of acute cerebral infarction, and improve clinical symptoms, decrease PTX-3, increase plaque stability, with good safety, which has a certain clinical application value.