目的 探讨尼麦角林片联合降纤酶注射液治疗短暂性脑缺血发作的临床疗效。方法 选取2018年3月-2018年12月在四川大学华西医院治疗的短暂性脑缺血发作患者236例，根据用药的差别分为对照组和治疗组，每组各118例。对照组静脉滴注降纤酶注射液，2 mL/次加入生理盐水250 mL，1次/d；治疗组在对照组基础上口服尼麦角林片，5 mg/次，3次/d。两组患者经2周治疗。观察两组患者临床疗效，同时比较治疗前后两组患者ABCD2、ESRS和SPI-Ⅱ评分，及基质金属蛋白酶9（MMP-9）、血管紧张素Ⅱ（Ang-Ⅱ）、同型半胱氨酸（Hcy）、趋化因子CXCL12、可溶性血管细胞黏附因子1（sVCAM-1）、血浆黏度（SV）、全血高切黏度（HBV）、全血低切黏度（LBV）、纤维蛋白原（FIB）及血小板聚集率（PAR）、血小板膜糖蛋白CD63、血小板膜糖蛋白CD62P和血小板膜糖蛋白纤维蛋白原受体（PAC-1）水平。结果 治疗后，对照组临床有效率为84.75%，显著低于治疗组的97.46%，两组比较差异有统计学意义（P<0.05）。治疗后，两组ABCD2评分、ESRS评分、SPI-Ⅱ评分均明显下降（P<0.05），且治疗组患者这些评分显著低于对照组（P<0.05）。治疗后，两组患者MMP-9、Ang-II、Hcy、CXCL12、sVCAM-1、FIB、LBV、HBV、SV、PAR、CD63、CD62P、PAC-1水平均显著降低（P<0.05），且治疗组患者这些指标水平显著低于对照组（P<0.05）。结论 尼麦角林片联合降纤酶注射液治疗短暂性脑缺血发作效果显著，可有效预防脑卒中的发生，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of niergoline combined with defibrase in treatment of transient ischemic attack. Methods Patients (236 cases) with transient ischemic attack in West China Hospital, Sichuan University from March 2018 to December 2018 were divided into control and treatment groups based on different treatments, and each group had 118 cases. Patients in the control group were iv administered with Defibrase Injection, 2 mL added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Nicergoline Tablets on the basis of the control group, 5 mg/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the ABCD2、ESRS and SPI-Ⅱ scores, the levels of MMP-9, Ang-II, Hcy, CXCL12, sVCAM-1, FIB, LBV, HBV, SV, PAR, CD63, CD62P and PAC-1 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 84.75%, which was significantly lower than 97.46% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the ABCD2, ESRS, and SPI-Ⅱ scores in two groups were significantly decreased (P<0.05), and these scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of MMP-9, Ang-II, Hcy, CXCL12, sVCAM-1, FIB, LBV, HBV, SV, PAR, CD63, CD62P, and PAC-1 in two groups were significantly decreased (P<0.05), and the indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Niergoline combined with defibrase in treatment of transient ischemic attack has a significant effect, can effectively prevent the stroke, which has a certain clinical application value.

R971