目的 分析果糖二磷酸钠联合阿替普酶治疗急性脑梗死的临床效果。方法 选取2017年1月-2019年1月安阳市第二人民医院收治的急性脑梗死患者93例，随机分为对照组（47例）和治疗组（46例）。对照组患者iv注射用阿替普酶，0.9 mg/kg，其中10%药量静脉推注1 min，剩下90%的药物静脉泵注1 h。治疗组在对照组的基础上口服果糖二磷酸钠片，4片/次，3次/d。两组患者均治疗2周。观察两组患者临床疗效，同时比较治疗前后两组患者生活能力和神经功能及血管内皮损伤情况。结果 治疗后，对照组和治疗组临床有效率分别为78.72%和91.30%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者Barthel明显升高（P<0.05），而NIHSS评分明显降低（P<0.05），且治疗组Barthel、NIHSS评分改善效果明显优于对照组（P<0.05）。治疗后，两组患者sTM和vWF水平均显著降低（P<0.05），且治疗组明显低于对照组（P<0.05）。结论 果糖二磷酸钠联合阿替普酶应治疗急性脑梗死患者具有良好临床效果，可明显提高患者生活能力，改善神经功能和血管内皮损伤。

Objective To analyze the clinical effect of fructose diphosphate sodium combined with alteplase in treatment of acute cerebral infarction. Methods Patients (93 cases) with acute cerebral infarction in the Second People's Hospital of Anyang from January 2017 to January 2019 were randomly divided into control (47 cases) and treatment (46 cases) groups. Patients in the control group were iv administered with Alteplase for injection, 0.9 mg/kg, 10% of the drug was injected intravenously for 1 min, and 90% of the drug was pumped intravenously for 1 h. Patients in the treatment group were po administered with Fructose Diphosphate Sodium Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the living ability, the neurological function, and the injury of vascular endothelial in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 78.72% and 91.30% respectively, and there were differences between two groups (P<0.05). After treatment, the Barthel score in two groups was significantly increased (P<0.05), the NIHSS score was significantly decreased (P<0.05), the Barthel and NIHSS score in the treatment group was significantly better than those in the control group (P<0.05). After treatment, the sTM and vWF level 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). Conclusion fructose diphosphate sodium combined with alteplase in treatment of acute cerebral infarction has better clinical therapeutic effect, can obviously improve the living ability of patients, and improve neurological function and vascular endothelial injury.

R971