目的 探讨利脑心片联合胞磷胆碱治疗急性脑梗死的临床疗效。方法 选取2018年1月-2022年1月北京市大兴区中西医结合医院急诊内科收治的200例急性脑梗死患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各100例。对照组患者静脉滴注胞磷胆碱钠注射液，0.5 g/次，加入5%葡萄糖注射液200 mL中滴注，1次/d。治疗组在对照组的基础上口服利脑心片，3片/次，3次/d。两组均用药14 d。观察两组的临床疗效，比较两组症状缓解时间，比较两组治疗前后社会活动功能量表（FAQ）评分、美国国立卫生院脑卒中量表（NIHSS）评分、白细胞介素-17（IL-17）、缺氧诱导因子-1α（HIF-1α）、血清基质金属蛋白酶-9（MMP-9）、脑源性神经营养因子（BDNF）水平的变化情况。结果 治疗后，治疗组患者总有效率是98.0%，显著高于对照组的89.0%（P<0.05）。治疗后，治疗组头晕、肢体活动障碍、肢体感觉异常、记忆力下降等症状改善时间均显著短于对照组（P<0.05）。治疗后，两组FAQ评分、NIHSS评分均较治疗前显著降低（P<0.05）；且治疗后，治疗组FAQ评分、NIHSS评分显著低于对照组（P<0.05）。治疗后，两组IL-17、HIF-1α、MMP-9水平均较治疗前显著降低，BDNF水平显著升高（P<0.05）；治疗后治疗组IL-17、HIF-1α、MMP-9水平低于对照组，而BDNF水平高于对照组（P<0.05）。结论 利脑心片联合胞磷胆碱治疗急性脑梗死疗效确切，可有效改善患者日常活动能力，并能降低脑神经损伤程度，减弱局部炎性反应，值得临床借鉴应用。

Objective To explore the clinical study of Linaoxin Tablets combined with citicoline sodium in treatment of acute cerebral infarction. Methods A total of 200 patients with acute cerebral infarction admitted to Department of Emergency of Beijing Daxing District Hospital of Integrated Traditional and Western Medicine from January 2018 to January 2022 were selected and divided intocontrol group and treatment group according to random number table method, with 100 patients in each group. Patients in the control group were iv administered with Citicoline Sodium Injection, 0.5g/time, added into 5% glucose injection 200 mL, once daily. Patients in the treatment group were po administered with Linaoxin Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the symptom relief time of the two groups was compared. The Social Activity Function Scale (FAQ) scores, National Institutes of Health Stroke Scale (NIHSS) scores, interleukin-17 (IL-17), hypoxia-inducing-factor-1α (HIF-1α), serum matrix metalloproteinase-9 (MMP-9) and brain-derived neurotrophic factor (BDNF) were compared between the two groups before and after treatment. Results After treatment, the total effective rate in the treatment group was 98.0%, which was significantly higher than 89.0% in the control group (P < 0.05). After treatment, the improvement time of dizziness, limb movement disorder, limb paresthesia, memory decline and other symptoms in the treatment group was significantly shorter than that in the control group (P< 0.05). After treatment, FAQ scores and NIHSS scores in both groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, FAQ scores and NIHSS scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of IL-17, HIF-1α and MMP-9 in two groups were significantly decreased compared with before treatment, and the level of BDNF was significantly increased (P < 0.05). After treatment, the levels of IL-17, HIF-1α and MMP-9 in the treatment group were lower than those in the control group, but the levels of BDNF were higher than those in the control group (P < 0.05). Conclusion Linaoxin Tablets combined with citicoline sodium has a definite therapeutic effect in treatment of acute cerebral infarction, and can effectively improve daily activity ability, reduce the degree of cranial nerve injury, and weaken local inflammatory response, which is worthy of clinical application.

R971

首都卫生发展科研专项项目（2022-2-7121）