目的 探讨复方脑肽节苷脂注射液联合盐酸替罗非班注射液治疗急性脑梗死的临床治疗效果。方法 选取2020年2月—2021年10月在安阳市第六人民医院治疗的82例急性脑梗死患者，根据随机数字表法将所有患者分为对照组和治疗组，各41例患者。对照组静脉滴注盐酸替罗非班注射液，50 mL加入250 mL生理盐水，1次/d。治疗组在对照组基础上静脉滴注复方脑肽节苷脂注射液，12 mL加入250 mL葡萄糖注射液充分稀释，1次/d。两组在治疗14 d后统计疗效。观察两组的临床疗效，比较两组的美国国立卫生研究院脑卒中量表（NIHSS）评分、弥散加权成像和Alberta卒中计划早期CT评分（DWI-ASPECTS）和基底动脉、椎动脉的血流速度的变化以及血清胰高血糖素样肽-1（GLP-1）、脑源性神经营养因子（BDNF）、神经特异性烯醇化酶（NSE）水平。结果 治疗后，治疗组患者的总有效率（90.24%）明显高于对照组的总有效率（73.17%），差异有统计学意义（P＜0.05）。治疗后，两组的NIHSS评分显著降低，DWI-ASPECTS评分显著升高（P＜0.05）；治疗后，治疗组的NIHSS评分比对照组低，DWI-ASPECTS评分比对照组高（P＜0.05）。治疗后，两组的基底动脉、椎动脉的血流速度显著升高（P＜0.05）；治疗组的基底动脉、椎动脉的血流速度比对照组升高更明显，差异有统计学意义（P＜0.05）。治疗后，两组的血清GLP-1、BDNF水平明显增多，血清NSE水平明显减少（P＜0.05）；治疗组的血清GLP-1、BDNF水平明显高于对照组，NSE水平明显低于对照组（P＜0.05）。结论 复方脑肽节苷脂注射液联合盐酸替罗非班注射液可提高急性脑梗死的疗效，改善神经功能、脑部血流和血清GLP-1、BDNF、NSE水平，安全性较好。

Objective To investigate the clinical efficacy of Compound Porcine Cerebroside and Ganglioside Injection combined with Tirofiban Hydrochloride Injection in treatment of acute cerebral infarction. Methods Patients (82 cases) with acute cerebral infarction in Anyang People's Hospital of No. 6 from February 2020 to October 2015 were divided into control and treatment groups according to the random number table method, and each group had 41 cases. Patients in the control group were iv administered with Tirofiban Hydrochloride Injection, 50 mL added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Compound Porcine Cerebroside and Ganglioside Injection on the basis of the control group, 12 mL added into glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and NIHSS score, DWI-ASPECTS score, the blood flow velocity of basilar artery and vertebral artery, and the levels of GLP-1, BDNF, and NSE in two groups were compared. Results After treatment, the total effective rate of the treatment group (90.24%) was significantly higher than 73.17% of the control group (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, but DWI-ASPECTS scores in two groups were significantly increased (P < 0.05). After treatment, the NIHSS score of the treatment group was lower than that of the control group, but the DWI-ASPECTS score was higher than that of the control group (P < 0.05). After treatment, the blood flow velocity of basilar artery and vertebral artery in two groups were significantly increased (P < 0.05). The blood flow velocity of basilar artery and vertebral artery in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the levels of GLP-1 and BDNF in two groups were significantly increased, but the level of NSE in two groups were significantly decreased (P < 0.05). The levels of GLP-1 and BDNF in the treatment group were significantly higher than those in the control group, but the level of NSE in the treatment group was significantly lower than those in the control group (P < 0.05). Conclusion Compound Porcine Cerebroside and Ganglioside Injection combined with Tirofiban Hydrochloride Injection can improve the therapeutic effect, neurological function, cerebral blood flow, and levels of GLP-1, BDNF, and NSE, with good safety.

R971

河南省医学科技攻关计划项目(LHGJ20190555)