目的 探讨复方曲肽注射液联合注射用降纤酶治疗急性脑梗死的临床疗效。方法 选取2017年5月-2019年5月在郑州人民医院治疗的104例急性脑梗死患者，根据用药差别分为对照组（52例）和治疗组（52例）。对照组静脉滴注注射用降纤酶，10单位加入生理盐水250 mL，1次/d；治疗组在对照组基础上静脉滴注复方曲肽注射液，10 mL加入生理盐水250 mL，1次/d。两组患者均经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ESRS、NIHSS、AD和mRS评分，血清和肽素（CPP）、血红素氧合酶1（HO1）、可溶性肿瘤坏死因子相关凋亡诱导配体（sTRAIL）、新蝶呤（Npt）、CXC趋化因子配体12（CXCL12）和血小板激活因子（PAF）水平，红细胞压积（HCT）、全血黏度（WBV）、纤维蛋白原（FIB）和血浆黏度（PV）水平，及相对平均血流量（Q_mean）、平均血流速度（V_mean）、动态阻力（DR）、特性阻抗（ZCV）和脑血管周围阻力（R）水平。结果 治疗后，对照组临床有效率为80.77%，显著低于治疗组的96.15%，两组比较差异有统计学意义（P<0.05）。经治疗，两组患者ESRS评分、NIHSS评分、mRS评分均明显降低（P<0.05），而ADL评分明显升高（P<0.05），且治疗组患者这些评分明显好于对照组（P<0.05）。经治疗，两组患者CPP、HO1、sTRAIL、Npt、CXCL12、PAF、HCT、WBV、FIB和PV水平明显降低（P<0.05），且治疗组患者明显低于对照组（P<0.05）。经治疗，两组患者Q_mean和V_mean显著降升高（P<0.05），DR、ZCV和R显著降低（P<0.05），且治疗组患者脑血流动力学明显好于对照组（P<0.05）。结论 复方曲肽注射液联合注射用降纤酶治疗急性脑梗死有利于促进患者脑神经功能恢复，提高患者生活质量、日常活动能力和降低脑血管事件发生风险。

Objective To investigate the clinical efficacy of Compound Troxerutin and Poreine Cerebroside Injection combined with Defibrase for injection in treatment of acute cerebral infarction. Methods Patients (104 cases) with acute cerebral infarction in Zhengzhou People's Hospital from May 2017 to May 2019 were divided into control (52 cases) and treatment (52 cases) groups based on different treatments. Patients in the control group were iv administered with Defibrase for injection, 10 unit added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Compound Troxerutin and Poreine Cerebroside Injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the ESRS scores, NIHSS scores, ADL scores, mRS scores, the serum level of CPP, HO1, sTRAIL, Npt, CXCL12 and PAF, HCT, WBV, FIB, PV, Q_mean, V_mean, DR, ZCV, and R levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.77%, which was significantly lower than 96.15% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the ESRS, NIHSS, and mRS scores in two groups were significantly decreased, but the ADL scores were significantly increased (P < 0.05), and these scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the level of CPP, HO1, sTRAIL, Npt, CXCL12, PAF, HCT, WBV, FIB, PV in two groups was significantly decreased (P < 0.05), and which in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the Q_mean and V_mean in two groups were significantly increased, but the DR, ZCV and R were significantly decreased (P < 0.05), and the cerebral hemodynamic indexes in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Compound Troxerutin and Poreine Cerebroside Injection combined with Defibrase for injection in treatment of acute cerebral infarction is conducive to promoting the recovery of nerve function, improving the quality of life, daily activity ability and reducing the risk of cerebrovascular events.

R971