目的 探讨尼麦角林联合奥扎格雷钠治疗急性脑梗死的临床效果。方法 选取2016年2月-2019年1月天津市第五中心医院收治的82例急性脑梗死患者，随机分成对照组和治疗组，每组各41例。对照组患者静脉滴注注射用奥扎格雷钠，80 mg溶于500 mL生理盐水，2次/d。治疗组在对照组基础上口服尼麦角林片，4片/次，2次/d，整片吞服。两组均连续治疗2周。观察两组的临床疗效，比较两组治疗前后血栓弹力图参数、血小板最大聚集率（MAR）、神经功能缺损程度、脑血流动力学指标、血小板（PLT）与淋巴细胞（LYM）比值（PLR）、中性粒细胞（NEUT）与LYM比值（NLR）的变化情况。结果 治疗后，对照组和治疗组的总有效率分别是80.5%、95.1%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组凝血反应时间（R）、血细胞凝集块形成的时间（K）均显著增大，而血细胞凝集块形成的速率（α角）、最大血块强度（MA）及MAR值均显著减小，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组R值、K值大于对照组，而α角、MA值及MAR值均小于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组NIHSS评分、外周阻力（Rv）均显著低于治疗前，而脑血流动力学指标中平均血流量（Q_mean）、血流速度（V_mean）值则均显著增加，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组NIHSS评分、Rv值低于对照组，而Q_mean、V_mean值则高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组外周血PLR、NLR水平较治疗前均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组PLR、NLR水平均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 尼麦角林联合奥扎格雷钠治疗急性脑梗死的整体疗效确切，能有效改善患者血液凝固性，抑制血小板过度激活，维持脑血流动力学稳定，减轻脑损伤，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of nicergoline combined with ozagrel sodium in treatment of acute cerebral infarction. Methods 82 Patients with acute cerebral infarction admitted to the Fifth Central Hospital of Tianjin from February 2016 to January 2019 were randomly divided into control (n=41) and treatment group (n=41). Patients in the control group were iv administered with Ozagrel Sodium for injection, 80 mg was dissolved in 500 mL normal saline, twice daily. Patients in the treatment group were po administered with Nicergoline Tablets, 4 tablets/time, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of thromboelastic parameters, MAR, neurological impairment degree, cerebral hemodynamic parameters, PLR and NLR in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.5% and 95.1%, respectively, and there were differences between two groups (P<0.05). After treatment, clotting reaction time (R) and hemagglutination time (K) in two groups were significantly increased, but rate of hemagglutination (α), maximum clot strength (MA) and MAR were significantly decreased, and there were differences in the same group (P<0.05). After treatment, the R and K in the treatment group were higher than those in the control group, but α, MA and MAR were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, NIHSS score and Rv in two groups were significantly decreased, but Q_mean and V_mean were significantly increased, and there were differences in the same group (P<0.05). After treatment, the NIHSS score and Rv in the treatment group were lower than those in the control group, but Q_mean and V_mean were higher than those in the control group, and there were differences between two groups (P<0.05). After treatment, PLR and NLR in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, PLR and NLR in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Nicergoline combined with ozagrel sodium has overall curative effect in treatment of acute cerebral infarction, and can effectively improve the blood coagulation, also can inhibit excessive activation of platelets, and can maintain hemodynamic stability of the brain, and can reduce brain injury, which has a certain clinical application value.