目的 探讨杏芎氯化钠注射液联合阿加曲班治疗急性脑梗死的临床疗效。方法 选取2022年6月—2023年7月延安大学咸阳医院收治的急性脑梗死患者108例，按照随机数字表法分为对照组（54例）和治疗组（54例）。对照组患者静脉泵注阿加曲班注射液，起始2 d剂量为2.5 mg/h，24 h持续，之后剂量为10 mg/次，在3 h左右完成静脉滴注，2次/d，此剂量连续使用5 d。治疗组患者在对照组基础上静脉滴注杏芎氯化钠注射液，100 mL/次，1次/d。两组患者治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者可溶性血管细胞黏附因子-1（sVCAM-1）、白细胞介素-1β（IL-1β）、D-二聚体和纤维蛋白原水平，及美国国立卫生研究院卒中量表（NIHSS）评分和90 d预后情况。结果 治疗后，治疗组总有效率为94.44%，比对照组的81.48%明显升高（P＜0.05）。治疗后，两组sVCAM-1、IL-1β、D-二聚体、纤维蛋白原水平和NIHSS评分明显降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗组90 d预后良好率为88.89%，对照组为74.07%，两组比较差异具有统计学意义（P＜0.05）。结论 杏芎氯化钠注射液联合阿加曲班对急性脑梗死的治疗效果以及安全性均较为理想，可改善体内炎症反应、血液高凝状态以及神经功能。

Objective To explore the therapeutic effect of Xingxiong Sodium Chloride Injection combined with agatroban in treatment of acute cerebral infarction. Methods Patients (108 cases) with acute cerebral infarction in Xianyang Hospital of Yan’an University from June 2022 to July 2023 were divided into control (54 cases) and treatment (54 cases) group according to the random number table method. Patients in the control group were iv administered with Argatroban Injection, the dose was 2.5 mg/h in the first 2 d, and then the dose was 10 mg/time, intravenous drip was completed in about 3 h, twice daily, and the dose was used continuously for 5 d. Patients in the treatment group were iv administered with Xingxiong Sodium Chloride Injection on the basis of the control group, 100 mL/time, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the levels of sVCAM-1, IL-1β, D-dimer and fibrinogen, NIHSS sores and 90 day prognosis in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 94.44%, which was significantly higher than that of the control group (81.48%,P < 0.05). After treatment, the levels of sVCAM-1, IL-1β, D-dimer, fibrinogen, and NIHSS scores in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). The rate of good prognosis at 90 days in the treatment group was 88.89%, while that in the control group was 74.07%, there was significant difference between two groups (P < 0.05). Conclusion Agatroban combined with Xingxiong Sodium Chloride Injection is effective and safe in the treatment of acute cerebral infarction, which can improve inflammatory reaction, blood hypercoagulable state and neurological function in vivo.

R971

陕西省科学技术研究发展计划项目（2020JM4149）