目的 分析曲克芦丁联合替罗非班治疗急性进展性脑梗死的临床疗效。方法 选取2020年1月—2023年8月巴彦淖尔市医院收治的126例急性进展性脑梗死患者，按随机数字表法分为对照组和治疗组，每组各63例。对照组静脉滴注盐酸替罗非班氯化钠注射液，开始以0.4 μg/(kg∙min)滴注30 min，后以0.1 μg/(kg∙min)维持72 h，之后继续常规治疗。治疗组在对照组治疗基础上静脉滴注曲克芦丁注射液，每次将0.3 g溶于5%葡萄糖注射液250 mL，1次/d。两组疗程均为2周。观察两组临床疗效，比较治疗前后两组患者相关量表[功能综合评定量表（FCA）、改良Barthel指数（MBI）等]评分、血小板参数[平均血小板体积（MPV）、血小板聚集率（PAgT）]及凝血指标[纤维蛋白原降解产物（FDP）、D-二聚体（D-D）]变化。结果 治疗后，治疗组总有效率93.65%，显著高于对照组的80.95%（P＜0.05）。治疗后，两组患者NIHSS评分显著降低，而FCA、MBI评分显著升高（P＜0.05）；治疗后，治疗组患者NIHSS、FCA、MBI评分改善优于对照组（P＜0.05）。治疗后，两组PLT均较同组治疗前显著升高，而MPV、PAgT均显著下降（P＜0.05）；治疗后，治疗组血小板参数改善优于对照组（P＜0.05）。治疗后，两组PT显著延长，而FDP、D-D均显著降低（P＜0.05）；治疗后，治疗组凝血指标改善优于对照组（P＜0.05）。结论 急性进展性脑梗死采用曲克芦丁联合替罗非班治疗安全性较佳，能有效提高救治效果，减轻神经功能损害，加速患者功能状态恢复，且在进一步调节机体凝血功能和抑制血栓形成方面具有优势。

Objective To analyze the clinical efficacy of troxerutin combined with tirofiban in treatment of acute progressive cerebral infarction. Methods A total of 126 patients with acute progressive cerebral infarction admitted to Bayannur Hospital from January 2020 to August 2023 were selected and divided into control group and treatment group according to random number table method, with 63 cases in each group. Patients in control group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection, the infusion was started at 0.4 μg/(kg∙min) for 30 min, then maintained at 0.1 μg/(kg∙min) for 72 h, after which routine therapy was continued. Patients in treatment group were iv administered with Troxerutin Injection on the basis of the control group, 0.3 g was dissolved in 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, theclinical efficacy was evaluated, changes of scores on relevant scales [functional comprehensive assessment (FCA), modified barthel index (MBI)], platelet parameters [mean platelet volume (MPV), platelet aggregation rate (PAgT)], and coagulation indicators [fibrinogen degradation products (FDP), D-dimer (D-D)] in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 93.65%, which was significantly higher than that of the control group (80.95%, P < 0.05). After treatment, NIHSS scores were significantly decreased, but FCA and MBI scores were significantly increased in both groups (P < 0.05). After treatment, NIHSS, FCA and MBI scores in the treatment group were better than those in the control group (P < 0.05). After treatment, PLT in two groups was significantly higher than before treatment, while MPV and PAgT were significantly decreased (P < 0.05). After treatment, the improvement of platelet parameters in the treatment group was better than that in the control group (P < 0.05). After treatment, PT was significantly prolonged, while FDP and D-D were significantly decreased in both groups (P < 0.05). After treatment, the improvement of coagulation index in treatment group was better than that in control group (P < 0.05). Conclusion The combination of troxerutin and tirofiban is safer for the treatment of acute progressive cerebral infarction, which can effectively improve the treatment effect, reduce neurological damage, accelerate the recovery of patients’ functional status, and have advantages in further regulating the body’s coagulation function and inhibiting thrombosis formation.

R971

巴彦淖尔市科技计划项目（K202028）