目的 探讨苦碟子注射液联合吡拉西坦治疗急性脑梗死的临床疗效。方法 选取2021年7月—2022年7月在开封市人民医院治疗的114例急性脑梗死患者，随机分为对照组（57例）和治疗组（57例）。对照组患者静脉滴注注射用吡拉西坦，4 g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苦碟子注射液，40 mL加入生理盐水250 mL，1次/d。两组患者连续治疗14 d。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生研究院卒中量表（NIHSS）、脑卒中专门化生活质量表（SS-QOL）和Barthel指数评分，梗死灶体积及脂蛋白相关磷脂酶A₂（Lp-PLA₂）、S100蛋白（S100β）、泛素羧基末端水解酶-L1（UCH-L1）、谷胱甘肽过氧化物酶（GSH-Px）、超氧化物歧化酶（SOD）和中性粒细胞/淋巴细胞比值（NLR）水平。结果 治疗后，对照组临床有效率为85.96%，治疗组临床有效率为96.49%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组NIHSS评分较治疗前明显下降，而SS-QOL、Barthel指数评分明显升高（P<0.05），且治疗组NIHSS评分低于对照组，SS-QOL、Barthel指数评分高于对照组（P<0.05）。治疗后，两组NLR、Lp-PLA₂、S100β、UCH-L1水平较治疗前均显著下降，而SOD、GSH-Px水平较治疗前显著提高（P<0.05），且治疗组NLR、Lp-PLA₂、S100β、UCH-L1、SOD、GSH-Px水平比对照组改善更明显（P<0.05）。治疗后，两组患者梗死灶体积较治疗前均显著降低（P<0.05），且治疗组梗死灶体积降低的更明显（P<0.05）。结论 苦碟子注射液联合吡拉西坦治疗急性脑梗死具有良好的临床疗效，可促进神经功能恢复，提升日常生活能力和生活质量，能抑制炎性反应和氧化应激反应，减轻神经细胞损伤。

Objective To explore the clinical efficacy of Kudiezi Injection combined with piracetam in treatment of acute cerebral infarction. Methods Patients (114 cases) with acute cerebral infarction in Kaifeng People's Hospital from July 2021 to July 2022 were randomly divided into control (57 cases) and treatment (57 cases) group. Patients in the control group were iv administered with Piracetam for injection, 4 g added into normal saline 250 mL, once daily. Patients in the treatment group were iv administered with Kudiezi Injection on the basis of the control group, 40 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, and the scores of NIHSS, SS-QOL and Barthel, the infarct volume, the levels of NLR, Lp-PLA2, S100β, UCH-L1, SOD and GSH-Px in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was 85.96%, and which in the treatment group was 96.49%. and the difference between the two groups was statistically significant (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased, while the scores of SS-QOL and Barthel index were significantly increased (P < 0.05), and the NIHSS score in the treatment group was lower than that of the control group, while the SS-QOL and Barthel index scores of the treatment group were higher than those of the control group (P < 0.05). After treatment, the levels of NLR, Lp-PLA2, S100β and UCH-L1 in two groups were significantly decreased, while the levels of SOD and GSH-Px were significantly increased in two groups (P < 0.05), and the improvement in the treatment group was more obvious than that in the control group (P < 0.05). After treatment, the infarctvolume in two groups was significantly lower than that before treatment (P < 0.05), and the infarct volume in the treatment group was decreased more significantly (P < 0.05). Conclusion Kudiezi Injection combined with piracetam has a good clinical effect in the treatment of acute cerebral infarction, which can promote the recovery of neurological function, improve the ability of daily life and quality of life, inhibit inflammatory reaction and oxidative stress reaction, and reduce nerve cell injury.

R971

河南省医学科技攻关计划（LHGJ20200843）