目的 探讨依折麦布片联合注射用尤瑞克林治疗老年急性脑梗死的效果。方法 选取陕西省核工业二一五医院2023年10月－2024年10月收治的130例老年急性脑梗死患者，按照随机数字表法将患者分为对照组和治疗组，每组各为65例。对照组静脉滴注0.15 PNA注射用尤瑞克林＋0.9%氯化钠注射液100 mL，1次/d。治疗组在对照组的基础上口服依折麦布片，10 mg/次，1次/d。两组均治疗2周。比较两组临床疗效、临床评分、脑血流灌注情况、血清因子指标。结果 治疗后治疗组的总有效率（92.31%）高于对照组的总有效率（75.38%，P＜0.05）。较治疗前，两组的改良Rankin量表（mRS）评分降低，简式Fugl-Meyer运动功能评分法（FMA）、简易智力状态检查量表（MMSE）评分升高（P<0.05）；治疗组较对照组mRS评分更低，FMA、MMSE评分更高（P＜0.05）。较治疗前，两组治疗后的血流平均通过时间（MTT）、峰值时间（TTP）缩短，局部脑血流量（CBF）、脑血容量（CBV）升高（P＜0.05）；治疗组较对照组MTT、TTP更短，CBF、CBV更高（P＜0.05）。较治疗前，两组治疗后的血清可溶性细胞黏附分子-1（sICAM-1）、基质金属蛋白酶-9（MMP-9）、白细胞介素-33（IL-33）、C反应蛋白（CRP）水平降低（P＜0.05），治疗组血清sICAM-1、MMP-9、IL-33、CRP水平较对照组更低（P＜0.05）。较治疗前，两组治疗后的血清微小核糖核酸-132（miR-132）、微小核糖核酸-146a（miR-146a）、神经营养因子（NTF）水平升高，血清神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）水平降低（P＜0.05）；较对照组，治疗组血清miR-132、miR-146a、NTF水平更高，血清NSE、MBP水平更低（P＜0.05）。结论 老年急性脑梗死患者使用依折麦布片联合注射用尤瑞克林治疗的疗效显著，与该治疗方案有效调节炎症指标、miR-132、miR-146a和神经因子水平，减轻机体炎症，改善脑血流灌注、神经、运动和认知功能有关。

Objective To investigate the effect of Ezetimibe Tablets combined with Urinary kallidinogenase for injection in treatment of acute cerebral infarction in the elderly.Methods 130 Elderly patients with acute cerebral infarction admitted to Shaanxi Nuclear Industry 215 Hospital from October 2023 to October 2024 were divided into control and treatment group using a random number table method, with 65 cases in each group. The control group received intravenous infusion of 0.15 PNA injection with 100 mL of Urinary kallidinogenase for injection + 0.9% sodium chloride injection, once daily. The treatment group received oral Ezetimibe Tablets on the base of the control group, 10 mg/time, once daily. Both groups were treated for 2 weeks. The clinical efficacy, clinical scores, cerebral blood flow perfusion, and serum factor indicators were compared between two groups.Results After treatment, the total effective rate of the treatment group (92.31%) was higher than that of the control group (75.38%, P < 0.05). Compared with before treatment, the mRS scores of both groups were decreased, while the FMA and MMSE scores were increased (P < 0.05). The treatment group had lower mRS scores and higher FMA and MMSE scores than those in the control group (P < 0.05). Compared with before treatment, MTT and TTP of blood flow in both groups after treatment were decreased, but CBF and CBV were increased (P < 0.05). The treatment group had shorter MTT and TTP, and higher CBF and CBV than those in the control group (P <0.05). Compared with before treatment, the levels of sICAM-1, MMP-9, IL-33, and CRP in two groups were decreased after treatment (P < 0.05). The levels of sICAM-1, MMP-9, IL-33, and CRP in the treatment group were lower than those in the control group (P < 0.05). Compared with before treatment, the serum levels of miR-132, miR-146a, and NFT were increased in both groups after treatment, while the serum levels of NSE and MBP were decreased (P < 0.05). Compared with the control group, the treatment group had higher serum levels of miR-132, miR-146a, and NFT, and lower serum levels of NSE and MBP (P < 0.05).Conclusion The treatment of elderly patients with acute cerebral infarction using Ezetimibe Tablets combined with Urinary kallidinogenase for injection has significant therapeutic effects, which is related to the effective regulation of inflammatory indicators, miR-132, miR-146a, and nerve factor levels using this treatment regimen, reducing inflammation, improving cerebral blood flow perfusion, nerve, motor, and cognitive functions.

R971

陕西省核工业二一五医院科研项目（215KYJJ-202212）