目的 通过倾向评分匹配法（PSM）评价己酮可可碱注射液治疗轻中度急性缺血性脑卒中患者的有效性和安全性。方法 纳入合肥市第一人民医院神经内科2023年10月—2024年3月急性脑卒中住院患者，所有患者按照此次住院期间有无使用己酮可可碱注射液分为治疗组和对照组，选择年龄、性别、住院天数、创伤侵入性操作、使用抗菌药物和使用精神药物共6个因素作为协变量，运用PSM法对两组1∶1匹配，收集匹配后两组患者美国国立卫生研究院卒中量表（NIHSS）、改良Rankin量表（MRS）、日常生活活动（ADL）评分结果和药物不良反应记录，计算两组治疗前后评分指标变化、治疗有效率和不良反应发生率。结果 匹配前共纳入患者348例，药物组∶对照组=81∶267，两组间住院日、创伤侵入性操作和使用抗菌药物等3个因素存在显著性差异（P<0.05）；采用PSM法平衡两组间混杂因素，两组匹配后均为70例，组间基线差异无显著性（P>0.05）；药物治疗后，对照组NIHSS、MRS评分较治疗前有显著改善（P<0.05）,ADL评分治疗前后变化无统计学意义（P>0.05），己酮可可碱组治疗后以上3个指标较治疗前均有明显改善，差异有统计学意义（P<0.05）；己酮可可碱治疗组治疗后NIHSS、MRS和ADL评分结果变化均优于对照组（P>0.05）；匹配后两组治疗总有效率分别为98.58%（治疗组）和92.86%（对照组），两组不良反应发生率分别为2.86%（治疗组）和1.43%（对照组）；两组匹配后总有效率和不良反应发生率差异均无统计学意义（P>0.05）。结论 PSM法适用于本研究，己酮可可碱治疗轻中度缺血性脑卒中患者安全有效，其相关评分指标优于对照组，但总体治疗有效率和对照组无显著性差异。

Objective To evaluate the effectiveness and safety of Pentoxifylline Injection in the treatment of mild to moderate acute ischemic stroke patients using propensity score matching method. Methods Patients with acute stroke admitted to the neurology department of the First People’s Hospital of Hefei from October 2023 to March 2024 were included. All patients were divided into a treatment group and a control group based on whether they used Ketoconazole Injection during their hospitalization. Six covariates, including age, gender, length of hospital stay, invasive procedures, use of antibiotics and use of psychotropic drugs were selected. The propensity score method was used to match the two groups in 1:1 ratio. The NIHSS score, MRS score, ADL score results and adverse drug reaction records of the matched patients were collected;then the changes in scoring indicators, treatment efficacy and incidence of adverse reactions before and after treatment were calculated for both groups. Result A total of 348 patients were enrolled before matching, with a drug group to control group ratio of 81:267. There were significant differences between the two groups in terms of length of hospital stay, invasive procedures and use of antibiotics（P＜0.05）. The propensity score method was used to balance the confounding factors between the two groups. After matching, there were 70 cases in both groups, and there was no significant difference in baseline between the groups（P＞0.05）; After drug treatment, the control group showed significant improvement in NIHSS score and MRS score compared to before treatment（P＜0.05）, while there was no statistically significant change in ADL score before and after treatment（P＞0.05）. The treatment group showed significant improvement in all three indicators after treatment compared to before treatment, with statistically significant differences（P＜0.05）; The changes in NIHSS score, MRS score, and ADL score in the treatment group were better than those in the control group after treatment（P＞0.05）; After matching, the total effective rates of the two treatment groups were 98.58%（treatment group） and 92.86%（control group）, respectively. The incidence of adverse reactions in the two groups was 2.86%（treatment group） and 1.43%（control group）, respectively; There was no statistically significant difference in the total effective rate and incidence of adverse reactions between the two groups after matching（P＞0.05）. Conclusion The propensity score matching method was applicable to this study. Pentoxifylline Injection was safe and effective in treating patients with mild to moderate ischemic stroke, and its related scoring indicators were better than those of the control group. However, there was no significant difference in overall treatment efficacy between the two groups.

R971

2024-2025年度安徽省中医药传承创新科研项目(2024CCCX234)