目的 观察注射用丹参多酚酸治疗急性脉络膜前动脉梗死的短期、长期疗效及安全性。方法 回顾性选取濮阳市安阳地区医院于2018年8月—2020年12月收治的102例急性脉络膜前动脉梗死患者为研究对象，随机分为对照组（n=50）和观察组（n=52）。两组患者中符合溶栓适应症，排除禁忌症，且经家属同意的，于发病4.5 h内给予溶栓治疗。对照组患者均给予常规抗血小板聚集、降脂稳定斑块、控制血压血糖等治疗措施；观察组在对照组常规治疗的基础上，住院当天给予注射用丹参多酚酸0.13 g，溶于0.9%氯化钠注射液250 mL中静脉滴注，1次/d，连用14 d。比较两组患者入院时、神经功能缺损最重时、治疗14 d后美国国立卫生研究院卒中量表（NIHSS）评分，及治疗3个月后改良Rankin量表（mRS）评分。随访治疗3个月后两组患者的全因死亡率及出血发生率以及不良反应发生情况。结果 两组患者在治疗前，一般资料、危险因素及NIHSS评分无统计学差异（P>0.05）。治疗过程中最重时的NIHSS评分，观察组较对照组低，但差异无统计学意义（P>0.05），治疗14 d后，观察组NIHSS评分显著低于对照组（P<0.05），3个月预后良好率（mRS评分≤2）显著高于对照组（P<0.05）。治疗3个月后，两组全因死亡率及出血发生率相比均无统计学意义。两组不良反应总发生率无统计学差异。结论 常规治疗联合应用注射用丹参多酚酸可以改善急性脉络膜前动脉短期及长期预后，且不增加不良反应，值得临床应用。

Objective To observe the short-term and long-term efficacy and safety of Salvianolic Acids for Injection in treatment of acute anterior choroidal artery infarction. Methods Total 102 patients with acute anterior choroidal artery infarction treated in Anyang District Hospital of Puyang City from August 2018 to December 2020 were randomly divided into control group (n=50) and observation group (n=52). The patients in two groups who met the thrombolytic indications, excluded the contraindications, and with the consent of their families, were given thrombolytic treatment within 4.5 hours of onset. Patients in the control group were given routine treatment measures such as anti platelet aggregation, reducing lipid and stabilizing plaque, controlling blood pressure and blood glucose. On the basis of routine treatment in the control group, patients in the observation group were given 0.13 g Salvianolic Acids for Injection and 250 mL of 0.9% sodium chloride injection on the day of hospitalization, once a day for 14 days. The scores of National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) after three months were compared between two groups. After three months of follow-up treatment, the all-cause mortality, bleeding rate and adverse reactions of two groups. Results There was no significant difference in general information, risk factors and NIHSS score between two groups before treatment (P>0.05). The NIHSS score of the observation group was lower than that of the control group, but the difference was not statistically significant (P>0.05). After 14 days of treatment, the NIHSS score of the observation group was significantly lower than that of the control group (P<0.05), and the good prognosis rate at three months (mRS score ≤ 2) was significantly higher than that of the control group (P<0.05). After three months of treatment, there was no significant difference in all-cause mortality and bleeding between two groups. There was no significant difference in the total incidence of adverse reactions between two groups. Conclusion Routine treatment combined with Salvianolic Acids for Injection can improve the short-term and long-term prognosis of acute anterior choroidal artery without increasing adverse reactions, which is worthy of clinical application.

R971

濮阳市科技攻关项目（1805069）