目的 探讨丹红注射液联合阿司匹林及氯吡格雷治疗短暂性脑缺血发作的临床疗效。方法 纳入2020年1月—2024年12月中国人民解放军联勤保障部队第九二八医院收治的短暂性脑缺血发作患者96例，随机分为对照组和治疗组，每组各48例。对照组给予双抗疗法，口服阿司匹林肠溶片100 mg/次，硫酸氢氯吡格雷片75 mg/次，1次/d。在对照基础上，治疗组静脉滴注丹红注射液，40 mL加入生理盐水250 mL中，1次/d。两组患者用药1周。观察两组患者临床疗效，比较治疗前后两组患者疾病发作持续时间和频率，凝血指标凝血酶时间（TT）、凝血酶原时间（PT）、纤维蛋白原（FIB）和活化的部分凝血活酶时间（APTT），及血小板分布宽度（PDW）、血小板与淋巴细胞比值（PLR）、平均血小板体积（MPV）和血清C反应蛋白（CRP）水平。结果 治疗后，治疗组总有效率（93.75%）明显高于对照组（79.17%，P＜0.05）。治疗后，两组疾病发作持续时间和频率均减少（P＜0.05），且治疗组均少于对照组（P＜0.05）。治疗后，两组凝血指标TT、PT、APTT显著延长，而FIB下降（P＜0.05），且治疗组凝血指标变化比对照组更显著（P＜0.05）。治疗后，两组PDW、PLR、MPV和血清CRP水平均显著下降（P＜0.05），且治疗组指标水平降低幅度比对照组更显著（P＜0.05）。结论 针对短暂性脑缺血发作联合应用丹红注射液与阿司匹林及氯吡格雷，安全性较佳，能有效抑制凝血亢进和血栓形成，阻断炎症级联反应，进一步控制疾病发作。

Objective To investigate the clinical efficacy of Danhong Injection combined with aspirin and clopidogrel in treatment of transient ischemic attack. Methods Patients (96 cases) with transient ischemic attack in 928 Hospital of PLA Joint Logistics Support Force from January 2020 to December 2024 were randomly divided into control and treatment group, and each group had 48 cases. Patient in the control group were administered with dual resistance therapy, they were po administered with Aspirin Enteric-coated Tablets 100 mg/time, Clopidogrel Bisulfate Tablets for 75 mg/time, once daily. Patient in the treatment group were iv administered with Danhong Injection on the basis of the control group, 40 mL added into normal saline 250 mL, once daily. Patient in two groups were treated for 1 week. After treatment, the clinical evaluations were evaluated, and the duration and frequency of transient ischemic disease attacks, coagulation indicators TT, PT, APTT and FIB, and the levels of PDW, PLR, MPV and serum CRP in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group (93.75%) was significantly higher than that in the control group (79.17%, P < 0.05). After treatment, the duration and frequency of disease attacks were decreased in two groups (P < 0.05), and which in the treatment group was less than that in the control group (P < 0.05). After treatment, the coagulation indicators TT, PT, and APTT were significantly prolonged in two groups, while the FIB content was decreased (P < 0.05). The changes of coagulation indicators in the treatment group were more significant than that in the control group (P < 0.05). After treatment, the levels of PDW, PLR, MPV and serum CRP in two groups were decreased significantly (P < 0.05), and the decrease levels in the treatment group was more significant than that in the control group (P < 0.05). Conclusion The combined use of Danhong Injection, aspirin, and clopidogrel for transient ischemic attacks has better safety and can effectively inhibit coagulation and thrombosis, block the inflammatory cascade reaction, and further control disease onset.

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