目的 探讨复方脑肽节苷脂联合奥扎格雷钠治疗急性进展性脑梗死的临床疗效。方法 选取2021年8月—2023年11月佳木斯市中心医院收治的104例急性进展性脑梗死患者，按随机数字表法将患者分为对照组和治疗组，每组各52例。对照组静脉滴注注射用奥扎格雷钠，80 mg/次，于0.9%氯化钠注射250 mL中充分溶解，2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，10 mg/次，于0.9%氯化钠注射250 mL中充分稀释，1次/d。两组疗程均为14 d。观察两组临床疗效，比较两组治疗前后美国国立卫生研究院卒中量表（NIHSS）评分、患侧大脑中动脉（MCA）血流动力学指标和血清髓鞘碱性蛋白（MBP）、基质金属蛋白酶-9（MMP-9）、高迁移率族蛋白B1（HMGB1）、碱性成纤维细胞生长因子（bFGF）水平。结果 治疗后，治疗组总有效率是90.38%，显著高于对照组的75.00%（P＜0.05）。治疗7、14 d后，治疗组NIHSS评分均较治疗前显著降低，对照组在治疗14 d后NIHSS评分明显降低（P＜0.05）；且治疗7、14 d后，治疗组NIHSS评分均显著低于同期对照组（P＜0.05）。治疗后，两组患侧MCA收缩期峰值血流速度（Vs）、舒张末期血流速度（Vd）、平均血流速度（Vm）均较同组治疗前显著升高（P＜0.05）；治疗后，治疗组脑血流动力学指标高于对照组（P＜0.05）。治疗后，两组血清MBP、MMP-9、bFGF、HMGB1水平显著降低（P＜0.05）；治疗后，治疗组血清MBP、MMP-9、bFGF、HMGB1水平低于对照组（P＜0.05）。结论 复方脑肽节苷脂联合奥扎格雷钠治疗急性进展性脑梗死具有较好的疗效，能在良好安全性的基础上有效促进神经功能恢复及炎症反应缓解，改善脑血流动力学，提高临床疗效。

Objective To explore the clinical efficacy of compound porcine cerebroside and ganglioside combined with ozagrel sodium in treatment of acute progressive cerebral infarction. Methods A total of 104 patients with acute progressive cerebral infarction admitted to Jiamusi Central Hospital from August 2021 to November 2023 were selected and divided into control group and treatment group according to random number table method, with 52 cases in each group. Patients in control group were iv administered with Ozagrel Sodium for injection, 80 mg/time, fully dissolved in 250 mL injection of 0.9% sodium chloride, twice daily. Patients in treatment group were iv administered with Compound Porcine Cerebroside and Ganglioside Injection on the basis of the control group, 10 mg/ time, fully diluted in 250 mL injection of 0.9% sodium chloride, once daily. The treatment course of both groups was 14 d. The clinical efficacy of the two groups was observed, and the changes of National Institutes of Health Stroke Scale (NIHSS) score, affected middle cerebral artery (MCA) hemodynamic indexes, serum myelin basic protein (MBP), matrix metalloproteinase-9 (MMP-9), high mobility group protein B1 (HMGB1), basic fibroblast growth factor (bFGF) levels before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 90.38%, which was significantly higher than that of the control group (75.00%, P < 0.05). After 7 and 14 d of treatment, the NIHSS score of the treatment group was significantly lower than that before treatment, and the NIHSS score of the control group was significantly lower after 14 d of treatment ( P < 0.05). After 7 and 14 d of treatment, NIHSS scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, MCA peak systolic blood flow velocity (Vs), end-diastolic blood flow velocity (Vd) and mean blood flow velocity (Vm) were significantly increased in both groups compared with before treatment (P < 0.05). After treatment, the cerebral hemodynamic indexes in the treatment group were higher than those in the control group (P < 0.05). After treatment, serum levels of MBP, MMP-9, bFGF and HMGB1 in two groups were significantly decreased (P < 0.05). After treatment, serum levels of MBP, MMP-9, bFGF and HMGB1 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Compound porcine cerebroside and ganglioside combined with ozagrel sodium has a good effect in treatment of acute progressive cerebral infarction, can effectively promote the recovery of nerve function and relieve inflammation on the basis of good safety, which can improve cerebral hemodynamics and clinical efficacy.

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