目的 探讨谷红注射液联合丹参多酚酸盐治疗急性脑梗死的临床效果。方法 选取2016年5月-2019年5月山东省耳鼻喉医院（山东省立医院西院）收治的脑梗死患者400例，随机分为对照组（200例）和治疗组（200例）。对照组静脉滴注注射用丹参多酚酸盐，200 mg/次加入生理盐水250 mL，1次/d。治疗组在对照组基础上静脉滴注谷红注射液，20 mL/次加入生理盐水250 mL，1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血浆黏度、全血低切黏度、血浆纤维蛋白原、全血高切黏度，以及肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、丙二醇（MDA）、超氧化物歧化酶（SOD）、单个核细胞血红素加氧酶（HO-1）和转录因子红系衍生核因子E2相关因子2（Nrf2）水平。结果 治疗后，对照组和治疗组临床有效率分别为86.00%和92.50%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血浆黏度、全血低切黏度、血浆纤维蛋白原和全血高切黏度均显著低于治疗前（P<0.05），且治疗组比对照组更低（P<0.05）。治疗后，两组患者TNF-α、IL-6、MDA水平均较治疗前显著降低（P<0.05），而SOD、HO-1和Nrf2水平显著高于治疗前（P<0.05），且治疗组患者上述指标明显好于对照组（P<0.05）。结论 谷红注射液联合丹参多酚酸盐治疗脑梗死疗效确切，可明显减轻炎性及氧化应激反应，安全性高。

Objective To explore the clinical effect of Guhong Injection combined with salvianolic acid salt in treatment of acute cerebral infarction. Methods Patients (400 cases) with acute cerebral infarction in Shandong ENT Hospital (Shandong Provincial Western Hospital) from May 2016 to May 2019 were randomly divided into control (200 cases) and treatment (200 cases) groups. Patients in the control group were iv administered with Salvianolic Acid Salt for injection, 200 mg added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Guhong Injection on the basis of the control group, 20 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 plasma viscosity, whole blood low shear viscosity, plasma fibrinogen, whole blood high shear viscosity, and the level of TNF-α, IL-6, MDA, SOD, HO-1 and Nrf2 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 86.00% and 92.50% respectively, and there were differences between two groups (P<0.05). After treatment, the plasma viscosity, whole blood low shear viscosity, plasma fibrinogen, whole blood high shear viscosity in two groups were significantly decreased (P<0.05), and the hemorheological indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-6 and MDA in two groups were significantly decreased (P<0.05), but the level of SOD, HO-1 and Nrf2 was significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Guhong Injection combined withsalvianolic acid salt in treatment of acute cerebral infarction has definite therapeutic effect, can obviously reduce inflammatory and oxidative stress reaction, and has a high safety.

R971

山东省科技发展计划项目（2015ZRC10126）