目的 研究脑心通胶囊联合注射用阿替普酶治疗急性脑梗死的临床疗效。方法 选取2018年12月—2019年12月在周口市第一人民医院治疗的100例急性脑梗死患者。将所有患者随机分为对照组和治疗组，每组各50例。对照组患者给予注射用阿替普酶，推荐剂量为0.9 mg/kg，总剂量的10%在1 min内先静脉推入，剩余剂量在随后60 min持续静脉滴注。治疗组在对照组基础上口服脑心通胶囊，2粒/次，3次/d，治疗时间为10 d。观察两组患者临床疗效，比较两组的欧洲生活质量（EuroQOL）评分、美国国立卫生研究院卒中量表（NIHSS）评分、大脑平均血流速度、血清因子水平。结果 治疗后，对照组和治疗组的总有效率分别为72.5%、90.0%，治疗组总有效率显著较高（P<0.05）。治疗后，两组患者NIHSS评分显著降低，EuroQOL评分显著升高（P<0.05），且治疗组NIHSS评分显著低于治疗组，EuroQOL评分显著高于治疗组（P<0.05）。治疗后，两组患者大脑前动脉、后动脉、中动脉的平均血流速度显著升高（P<0.05），且治疗组大脑前动脉、后动脉、中动脉的平均血流速度明显高于对照组（P<0.05）。治疗后，两组血清神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）、超敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）水平显著降低（P<0.05）；并且治疗组血清NSE、MBP、hs-CRP和Hcy水平均显著低于对照组（P<0.05）。结论 脑心通胶囊联合注射用阿替普酶治疗急性脑梗死具有较好的疗效，能够改善患者神经功能，提高患者生活质量，升高大脑平均血流速度，降低血清因子水平。

Objective To study the efficacy of Naoxintong Capsules combined with Alteplase for injection in treatment of acute cerebral infarction. Methods Patients (100 cases) with acute cerebral infarction in Zhoukou First People's Hospital from December 2018 to December 2019 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were given Alteplase for injection, the recommended dose was 0.9 mg/kg, 10% of the total dose was injected intravenously within 1 min, and the remaining dose was continuously infused in the following 60 min. Patients in the treatment group were po administered with Naoxintong Capsules on the basis of the control group, 2 grains/time, three times daily, treated for 10 d. After treatment, the clinical efficacies were evaluated, and EuroQOL scores, NIHSS scores, the mean blood flow velocity of cerebral artery, the serum factor levels in two groups were compared. Results After treatment, the total effective rate of the control group and the treatment group were 72.5% and 90.0%, respectively, and the total effective rate of the treatment group was significantly higher than that in the control group (P<0.05). After treatment, NIHSS score of two groups was significantly decreased, but EuroQol score of two groups was significantly increased (P<0.05), and the NIHSS score of the treatment group was significantly lower than that of the treatment group, but EuroQol score was significantly higher than that of the treatment group (P<0.05). After treatment, the average blood flow velocity of anterior cerebral artery, posterior artery and middle artery in two groups were significantly increased (P<0.05), and the average blood flow velocity of anterior cerebral artery, posterior artery and middle artery in treatment group was significantly higher than those in control group (P<0.05). After treatment, the levels of NSE, MBP, hs-CRP, and Hcy in two groups were significantly decreased (P<0.05), and the levels of NSE, MBP, hs-CRP, and Hcy in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Naoxintong Capsules combined with Alteplase for injection has clinical curative effect in treatment of acute cerebral infarction, can improve the neurological function of patients, improve the quality of life of patients, increase the average cerebral blood flow velocity, and reduce the serum level of inflammatory factors.

R971