目的 探讨注射用丹参多酚酸盐联合长春西汀注射液治疗腔隙性脑梗死的临床疗效。方法 选取2018年1月-2019年9月天津市环湖医院收治的92例腔隙性脑梗死患者作为研究对象，按照随机数字表法将全部患者分为对照组和治疗组，每组各46例。对照组静脉滴注长春西汀注射液，30 mg/次，1次/d。治疗组在对照组治疗的基础上静脉滴注注射用丹参多酚酸盐，200 mg/次，1次/d。两组患者均连续治疗2周。比较两组患者治疗后的总有效率，并比较两组的神经功能缺损程度、血流动力学指标、细胞因子水平。结果 在治疗后，治疗组患者的总有效率比对照组高，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者的NIHSS评分明显低于治疗前（P<0.05）；治疗后治疗组的NIHSS评分比对照组低，差异有统计学意义（P<0.05）。治疗后，两组的搏动指数、阻力指数均明显降低，平均血流速度明显升高（P<0.05）；治疗后治疗组的搏动指数、阻力指数比对照组低，平均血流速度比对照组高，差异有统计学意义（P<0.05）。治疗后，两组的C反应蛋白（CRP）、同型半胱氨酸（Hcy）、内皮素-1（ET-1）水平均明显低于治疗前，一氧化氮（NO）明显高于治疗前（P<0.05）；治疗后治疗组的CRP、Hcy、ET-1水平均比对照组低，NO水平比对照组高，差异有统计学意义（P<0.05）。结论 注射用丹参多酚酸盐联合长春西汀注射液可提高腔隙性脑梗死的疗效，减轻神经功能损伤，改善血流动力学水平和细胞因子水平，具有一定的临床研究价值。

Objective To investigate the clinical effect of Salvianolate for injection combined with Vinpocetine Injection in treatment of lacunar infarction. Methods Patients (92 cases) with lacunar infarction in Tianjin Huanhu Hospital from January 2018 to September 2019 were divided into control and treatment groups according to the random number table methods, and each group had 46 cases. Patients in the control group were iv administered with Vinpocetine Injection, 30 mg/time, once daily. Patients in the treatment group were iv administered with Salvianolate for injection on the basis of the control group, 200 mg/time, once daily. Patients in two groups were treated for 2 weeks. After treatment, the total effective rate was evaluated, and the degree of neurological deficit, hemodynamic index, and cytokine level in two groups before and after treatment were compared. Results The total effective rate in the treatment group was higher than that in the control group (P<0.05). After treatment, the NIHSS scores in two groups were significantly decreased (P<0.05), and the NIHSS scores in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, pulsation index and resistance index in two groups were significantly decreased but the average blood flow velocity was significantly increased (P<0.05). The pulsation index and resistance index in the treatment group were lower than those in the control group, but the average blood flow velocity in the treatment group was higher than that in the control group (P<0.05). After treatment, the levels of CRP, Hcy, and ET-1 in two groups were significantly decreased (P<0.05), and the levels of CRP, Hcy, and ET-1 in the treatment group were lower than those in the control group (P<0.05). Conclusion Salvianolate for injection combined with Vinpocetine Injection has clinical curative effect in treatment of lacunar infarction, can reduce the damage of nerve function and improve the levels of hemodynamics and cytokines, which has a certain clinical application value.

R971

天津市教委科研计划项目（2018KJ009）