目的 探讨注射用丹参多酚酸对急性脑梗死合并糖尿病患者的临床疗效、认知功能、抗氧化能力以及血管内皮功能的影响。方法 选取2017年4月-2019年3月河南大学第一附属医院诊治的急性脑梗死合并糖尿病患者92例作为研究对象，按随机数字表法将患者随机分为对照组和观察组，每组各46例。对照组患者均根据具体病情采取对症内科综合治疗方案，而观察组患者在此基础上静脉滴注注射用丹参多酚酸，0.13 g加入到0.9%氯化钠注射液250 mL，1次/d。两组均治疗2周后评价疗效。观察两组患者的临床疗效，同时比较两组患者治疗前后的认知功能、抗氧化指标以及血管内皮功能指标。结果 治疗后，对照组总有效率为80.4%，显著低于观察组的91.3%，两组比较存在显著性差异（P<0.05）。治疗后，两组患者的简易精神状态量表（MMSE）和蒙特利尔认知评估量表法（MoCA）评分均明显升高，同组治疗前后差异具有统计学意义（P<0.05），且观察组MMSE和MOCA评分明显高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的超氧化物歧化酶（SOD）水平明显升高，丙二醛（MDA）水平明显降低，同组治疗前后比较差异存在统计学意义（P<0.05），且观察组SOD和MDA水平显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的内皮素-1（ET-1）水平明显降低，血管内皮生长因子（VEGF）、一氧化氮（NO）水平明显升高，同组治疗前后间差异具有统计学意义（P<0.05），且观察组血管内皮功能指标水平显著优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 在基本对症治疗方案的前提下使用注射用丹参多酚酸治疗急性脑梗死合并糖尿病的患者，不仅能够显著改善患者的临床症状与体征，进一步提高患者的认知功能，而且能够对机体的抗氧化、血管内皮功能产生明确的改善效果，值得临床上进一步研究使用。

Objective To investigate the effects of Salvianolic Acids for Injection on the clinical efficacy, cognitive function, antioxidant capacity and vascular endothelial function of patients with acute cerebral infarction complicated with diabetes. Methods A total of 92 patients with acute cerebral infarction complicated with diabetes who were diagnosed and treated in the The First Affiliated Hospital of Henan University from April 2017 to March 2019 were selected as the research objects. According to the random number table method, the patients were randomly divided into the control group and the observation group, with 46 patients in each group. Patients in the control group were given comprehensive symptomatic medical treatment according to their specific conditions, while patients in the observation group were iv administered with Salvianolic Acids for Injection and 0.13 g added into 0.9% sodium chloride injection 250 mL, once daily. Both groups were evaluated after 2 weeks of treatment. The clinical efficacy in two groups of patients was observed, and the cognitive function, antioxidant index and vascular endothelial function index before and after treatment were compared between two groups. Results After treatment, the total effective rate in the control group was 80.4%, which was significantly lower than 91.3% of the observation group, with significant difference between the two groups (P<0.05). After treatment, MMSE and MOCA scores of both groups were significantly increased, and the difference in the same group before and after treatment was statistically significant (P<0.05). After treatment, MMSE and MOCA scores of the observation group were significantly higher than those of the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the level of SOD was significantly increased, but MDA was significantly decreased, and the difference in the same group before and after treatment was statistically significant (P<0.05), and the levels of SOD and MDA in the observation group were significantly better than those in the control group, and the difference between two groups was also statistically significant (P<0.05). After treatment, ET-1 level was significantly decreased, but the levels of VEGF and NO in two groups were significantly increased, and the differences in the same group before and after treatment were statistically significant (P<0.05). Moreover, the vascular endothelial function index levels in the observation group was significantly better than that in the control group, and the differences between the two groups were statistically significant (P<0.05). Conclusion Under the premise of the basic symptomatic treatment plan, Salvianolic Acids for Injection in treatment of patients with acute cerebral infarction complicated with diabetes can not only significantly improve the clinical symptoms and signs of the patients, further improve the patients' cognitive function, but also produce a definite improvement effect on the body's antioxidant and vascular endothelial function, which is worthy of further clinical study.

R971

河南省医学科技攻关计划项目（201702133）