目的 探讨注射用灯盏花素联合丁苯酞氯化钠注射液治疗急性脑梗死的临床疗效。方法 选取2018年1月—2020年12月滁州市中西医结合医院收治的80例急性脑梗死患者作为研究对象，按照治疗方法将患者分为对照组和观察组，每组各40例。对照组静脉滴注丁苯酞氯化钠注射液，100 mL/次，2次/d。观察组在对照组基础上静脉滴注注射用灯盏花素，20 mg加入250 mL生理盐水，1次/d。两组均连续治疗14 d。观察两组患者的临床疗效，比较两组治疗前后的NIHSS评分、血清淀粉样蛋白A（SAA）、同型半胱氨酸（Hcy）、人趋化素（Chemerin）的水平，以及患者缺血低灌注区面积。结果 治疗后，观察组的总有效率为95.00%，明显高于对照组的80.00%，差异有统计学意义（P<0.05）。治疗后，两组NIHSS评分明显降低（P<0.05），且观察组NIHSS评分显著低于对照组（P<0.05）。治疗后，两组的SAA、Hcy、Chemerin水平均显著降低（P<0.05）；治疗后，观察组的SAA、Hcy、Chemerin显著低于对照组，差异有统计学意义（P<0.05）。治疗后，两组的缺血低灌注区面积显著缩小（P<0.05），且观察组显著低于对照组（P<0.05）。结论 注射用灯盏花素联合丁苯酞氯化钠注射液治疗急性脑梗死的疗效显著，可改善患者神经功能，缩小缺血低灌注区面积，降低SAA、Hcy、Chemerin的水平，具有良好的安全性。

Objective To investigate the clinical efficacy of Breviscapine for injection combined with Butylphthalide and Sodium Chloride Injection in treatment of acute cerebral infarction. Methods Eighty cases of acute cerebral infarction patients treated in Chuzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2018 to December 2020 were selected as the research object, and the patients were divided into control group and observation group according to the treatment method, with 40 cases in each group. Patients in the control group was intravenously injected with Butylphthalide and Sodium Chloride Injection, 100 mL time, twice daily. Patients in the observation group were administered with Breviscapine for injection on the basis of control group, 20 mg added with 250 mL normal saline, once daily. Both groups were treated continuously for 14 d. Clinical efficacy of two groups was observed, and NIHSS scores, serum SAA, Hcy, Chemerin levels, and the area of ischemia and hypoperfusion area of two groups were compared before and after treatment. Results After treatment, the total effective rate of the observation group was 95.00%, significantly higher than 80.00% of the control group, and the difference was statistically significant (P < 0.05). After treatment, the NIHSS scores in two groups were significantly decreased (P < 0.05), and the NIHSS scores in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of SAA, Hcy and Chemerin in two groups were significantly decreased (P < 0.05). After treatment, SAA, Hcy and Chemerin in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). After treatment, the area of ischemic hypoperfusion area in both groups was significantly reduced (P < 0.05), and the observation group was significantly lower than the control group (P < 0.05). Conclusion Breviscapine for injection combined with Butylphthalide and Sodium Chloride Injection has significant efficacy in treatment of acute cerebral infarction, which can improve the neurological function of patients, reduce the area of ischemia and low perfusion area, and reduce the levels of SAA, Hcy, and Chemerin, showing good safety.

R971

国家自然科学基金资助项目（82060894）