目的 研究曲克芦丁联合双重抗血小板治疗对脑梗死患者临床疗效、凝血功能和神经功能的影响。方法 选择2016年1月—2018年12月河南省洛阳市第三人民医院神经内科的84例脑梗死患者，用抽签法随机分为对照组和观察组，每组各42例。对照组采用双重抗血小板治疗，口服硫酸氢氯吡格雷片75 mg/d和阿司匹林肠溶片100 mg/d。观察组在对照组治疗的基础上联合曲克芦丁片，1片/d。两组均治疗14 d。观察两组患者的临床疗效，同时比较两组患者凝血功能和神经功能指标。结果 治疗后，观察组治疗的总有效率为90.48%，明显高于对照组的76.19%（P<0.05）。两组治疗后的纤维蛋白原、血小板计数和二聚体均明显降低（P<0.05），且观察组凝血功能指标水平均明显低于对照组（P<0.05）。两组治疗后的NIHSS评分和改良Rankin评分均明显降低（P<0.05）；且观察组NIHSS评分和改良Rankin评分明显低于对照组（P<0.05）。两组治疗后的神经元特异性烯醇化酶（NSE）水平明显降低，神经营养因子（NTF）和神经生长因子（NGF）水平均明显升高（P<0.05）；且观察组神经细胞因子水平明显优于对照组（P<0.05）。结论 曲克芦丁联合双重抗血小板方案治疗能改善脑梗死患者的凝血功能和神经功能，促进功能恢复，且安全性较好，具有临床推广应用价值。

Objective To study the effect of troxerutin combined with dual antiplatelet regimens on clinical efficacy, blood coagulation and neurological function in patients with cerebral infarction. Methods 84 cases of patients with cerebral infarction who were treated in Luoyang Third People's Hospital from January 2016 to December 2018 werer divided into control and observation groups randomly, and each group had 42 cases. Patients in the control group were given dual antiplatelet regimens, po administered with Clopidogrel Hydrogen Sulphate Tablets 75 mg/d, and Aspirin Enteric-coated Tablets 100 mg/d. Patients in the observation group were po administered with Troxerutin Tablets on the basis of control group, 1 tablet daily. Patients in two groups were treated for 14 d. The clinical efficacy of the two groups was observed, and the indicators of coagulation function and nerve function were compared between two groups. Results After treatment, the total effective rate of the observation group was 90.48%, which was significantly higher than 76.19% of the control group (P<0.05). After treatment, fibrinogen, platelet count and dimer in two groups were significantly decreased (P<0.05), and coagulation function indexes in the observation group were significantly lower than those in the control group (P<0.05). After treatment, NIHSS score and modified Rankin score were significantly reduced after treatment in two groups (P<0.05). And NIHSS score and modified Rankin score in the observation group were significantly lower than those in the control group (P<0.05). After treatment, NSE level in two groups were decreased, but the levels of NTF and NGF were significantly increased (P<0.05), and nerve cytokine levels in the observation group were significantly better than those in the control group (P<0.05). Conclusion Troxrutin combined with dual anti-platelet therapy can improve the coagulation and nerve functions of patients with cerebral infarction, promote functional recovery, and is safe, with clinical application value.

R971

河南省科技发展项目（0624410102）