目的 观察注射用丹参多酚酸对急性缺血性脑卒中患者细胞间黏附因子-1（ICAM-1）、胆红素及早期神经功能的影响，探讨注射用丹参多酚酸可能的作用机制。方法 回顾性以2020年1月—2020年10月在保定市第一中心医院神经内科住院的急性缺血性脑卒中患者100例为研究对象，根据治疗措施不同分为对照组和试验组，每组各50例。对照组为常规抗栓治疗，试验组在对照组基础上加用注射用丹参多酚酸，每次取0.13 g加入0.9%氯化钠注射液250 mL中稀释，静脉滴注，每天1次。两组均连续治疗14 d。在入院第1天、第14天分别收集患者血清，测定ICAM-1、胆红素水平，并应用美国国立卫生研究院卒中量表（NIHSS）评估患者的神经功能，评定两组治疗疗效，并观察治疗期间不良反应发生情况。结果 两组治疗前ICAM-1、胆红素水平及NIHSS评分比较，差异无统计学意义（P＞0.05）。两组治疗后NIHSS评分均较本组治疗前显著降低（P＜0.05），且试验组NIHSS评分明显低于对照组（P＜0.05）。治疗后，对照组胆红素水平较本组治疗前显著降低（P＜0.05），但试验组胆红素水平较本组治疗前显著升高，且高于对照组治疗后水平（P＜0.05）；两组ICAM-1水平均较本组治疗前显著降低（P＜0.05），且试验组ICAM-1水平下降程度较对照组显著（P＜0.05）。试验组的治疗总有效率高于对照组（P＜0.05）。结论 注射用丹参多酚酸可能通过降低ICAM-1水平，升高胆红素水平发挥神经保护作用，改善缺血性脑卒中患者神经功能。

Objective To observe the effects of Salvianolic Acid for Injection on intercellular cell adhesion molecule-1 (ICAM-1) bilirubin and early neurological function in patients with acute ischemic stroke, and to explore the possible mechanism of action of Salvianolic Acid for Injection. Methods A total of 100 patients with acute ischemic stroke hospitalized in Baoding NO.1 Central Hospital from January 2020 to October 2020 were retrospectively taken as the research objects. According to different treatment measures, they were divided into the control group and the experimental group, with 50 cases in each group. Patients in the control group received routine antithrombotic treatment, while patients in the experimental group received Salvianolic Acid for Injection on the basis of the control group. 0.13 g Salvianolic Acid for Injection was added to 250 mL of 0.9% Sodium Chloride Injection and diluted intravenously once a day. Both groups were treated continuously for 14 days. On the first and 14th day of admission, serum samples were collected from patients, and ICAM-1 and bilirubin levels were measured. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the patient's neurological function, the treatment efficacy of the two groups were evaluated, and the occurrence of adverse reactions were observed during the treatment period. Results There was no statistically significant difference in ICAM-1, bilirubin levels, and NIHSS scores between the two groups before treatment (P＞0.05). After treatment, the NIHSS score of both groups significantly decreased compared to before treatment in same group (P＜0.05), and the NIHSS score of the experimental group was significantly lower than that of the control group (P＜0.05). After treatment, the bilirubin level in the control group significantly decreased compared to before treatment in same group (P＜0.05), but the bilirubin level in the experimental group significantly increased compared to before treatment in same group, and was higher than the level in the control group after treatment (P＜0.05). The level of ICAM-1 in both groups were significantly reduced compared to before treatment in same group (P＜0.05), and the level of ICAM-1 in the experimental group decreased significantly compared to the control group (P＜0.05). The total effective rate of treatment in the experimental group was higher than that in the control group (P＜0.05). Conclusion Salvianolic Acid for Injection may exert neuroprotective effects by reducing ICAM-1 level and increasing bilirubin level, thereby improving neurological function in patients with ischemic stroke.

R971

河北省医学研究重点课题计划项目（20181487）