目的 探究盐酸川芎嗪注射液和阿加曲班联合治疗急性脑梗死的临床疗效。方法 选取2023年6月—2025年6月北京大学第三医院秦皇岛医院收治的186例急性脑梗死患者，基于随机数字表法将患者分为对照组和治疗组，各93例。对照组给予阿加曲班注射液治疗，第1～2 d将20 mL阿加曲班注射液与80 mL生理盐水充分均匀稀释，静脉泵入，输注速度设置为25 mL/h，第3天开始，使用频次减至2次/d，剂量为20 mL/次。治疗组在对照组基础上静脉滴注盐酸川芎嗪注射液，将40 mg盐酸川芎嗪注射液与250 mL生理盐水充分均匀稀释，1次/d。两组治疗时间为14 d。观察两组临床疗效，比较患者超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、丙二醛（MDA）、血清妊娠相关血浆蛋白A（PAPP-A）、氧化型低密度脂蛋白（ox-LDL）的变化。结果 治疗后，治疗组总有效率是95.70%，较对照组总有效率87.10%更高（P＜0.05）。治疗后，两组患者SOD、GSH-Px水平较前显著升高，而MDA水平降低（P＜0.05）；治疗后，较对照组，治疗组SOD、GSH-Px水平更高，MDA水平更低（P＜0.05）。治疗后，两组PAPP-A、ox-LDL水平均较前显著降低（P＜0.05）；较对照组，治疗后治疗组PAPP-A、ox-LDL水平均更低（P＜0.05）。结论 盐酸川芎嗪注射液和阿加曲班联合治疗急性脑梗死患者有助于提高疗效，减轻氧化应激反应，降低PAPP-A、ox-LDL水平，且用药安全性高，具有推广价值。

Objective To investigate the clinical efficacy of Ligustrazine Hydrochloride Injection combined with argatroban in treatment of acute cerebral infarction. Methods A total of 186 patients with acute cerebral infarction who were admitted to Peking University Third Hospital Qinhuangdao Hospital from June 2023 to June 2025 were selected. Based on the random number table method, the patients were divided into control group and treatment group, with 93 cases in each group. Patients in control group were treated with Argatroban Injection, on days 1 to 2, 20 mL of Argatroban Injection was thoroughly and evenly diluted with 80 mL of normal saline, and then infused intravenously at a rate of 25 mL/h. From the 3rd day onward, the frequency was reduced to 2 times per day, with a dose of 20 mL per time. Patients in treatment group were given intravenous infusion of Ligustrazine Hydrochloride Injection on the basis of control group. 40 mg of Ligustrazine Hydrochloride Injection was thoroughly and evenly diluted with 250 mL of normal saline, and administered once per day. The treatment duration for both groups was 14 d. The clinical efficacy of two groups was observed, and the changes in SOD, GSH-Px, MDA, serum PAPP-A, and ox-LDL of the patients were compared. Results After treatment, the total effective rate of treatment group was 95.70%, which was higher than that of control group (87.10%) (P < 0.05). After treatment, the levels of SOD and GSH-Px in both groups significantly increased compared to before, while the MDA level decreased (P < 0.05). After treatment, compared with control group, the levels of SOD and GSH-Px in treatment group were higher, and the MDA level was lower (P < 0.05). After treatment, the levels of PAPP-A and ox-LDL in both groups significantly decreased compared to before (P < 0.05). Compared with control group, the levels of PAPP-A and ox-LDL in treatment group were lower after treatment (P < 0.05). Conclusion The combined use of Ligustrazine Hydrochloride Injection and argatroban in treatment of patients with acute cerebral infarction can help improve the therapeutic effect, reduce oxidative stress response, lower the levels of PAPP-A and ox-LDL, and has high safety in medication use, thus having promotional value.

R971

秦皇岛市科技计划项目（202401A035）