注射用丹参多酚酸盐联合替罗非班治疗急性脑梗死的疗效观察  

Observation on the therapeutic effect of Salvia miltiorrhiza polyphenolate injection combined with tirofiban on patients with acute cerebral infarction

作　　者：张亚伟 齐赛卿 申志国 李君朝 ZHANG Yawei;QI Saiqing;SHEN Zhiguo;LI Junchao(Department of Clinical Pharmacy,Fengfeng General Hospital of North China Medical and Health Group,Handan 056200,China;Department of Neurology,Fengfeng General Hospital of North China Medical and Health Group,Handan 056200,China;Department of Neurology,Handan Hangang Hospital)

机构地区：[1]华北医疗健康集团峰峰总医院临床药学部,056200 [2]华北医疗健康集团峰峰总医院神经内科,056200 [3]邯郸邯钢医院神经内科

出　　处：《天津医药》2025年第2期203-207,共5页Tianjin Medical Journal

基　　金：邯郸市科技计划项目(22422083093ZC)。

摘　　要：目的 探究注射用丹参多酚酸盐联合替罗非班对急性脑梗死(ACI)患者疗效、巨噬细胞移动抑制因子(MIF)水平及血流变的影响。方法 采用随机数字表法将116例ACI患者分为西药组(给予替罗非班治疗)和联合组(给予注射用丹参多酚酸盐联合替罗非班治疗),各58例。计算神经功能缺损评分(NIHSS)降低程度并评估疗效;采用酶联免疫吸附试验(ELISA)检测治疗前后患者血清MIF、白细胞介素(IL)-6、IL-1β水平;采用SA-6600型全自动血液流变仪检测治疗前后ACI患者血流变指标(全血黏度、全血低切黏度和纤维蛋白原)的变化;记录治疗期间不良反应的发生情况;采用改良Rankin量表(mRS)评估发病90 d时的临床转归情况,Barthel指数评估患者治疗前后的生活能力。结果 联合组ACI患者的临床总有效率高于西药组(89.66%vs. 74.14%,P<0.05)。治疗后,2组MIF、血流变指标、IL-6和IL-1β水平均低于治疗前,且联合组低于西药组(P<0.05)。2组不良反应总发生率差异无统计学意义(P>0.05)。2组治疗后Barthel指数均较治疗前增加,且联合组高于西药组(P<0.05);联合组转归良好率高于西药组(51.72%vs. 32.76%,P<0.05)。结论 注射用丹参多酚酸盐联合替罗非班治疗ACI疗效确切,可降低血清MIF及炎性因子水平,改善患者血流变指标,安全性好。Objective To investigate the influence of Salvia miltiorrhiza polyphenolate injection combined with tirofiban on the curative effect,macrophage migration inhibitory factor(MIF)level and hemorheology in patients with acute cerebral infarction(ACI).Methods A total of 116 patients with ACI were divided into the western medicine group(treated with tirofiban)and the combined group(treated with Salvia miltiorrhiza polyphenolate injection combined with tirofiban)by random number table method,with 58 cases in each group.Neurological deficit score(NIHSS)reduction was calculated,and the therapeutic effect was evaluated.Serum MIF,interleukin(IL)-6 and IL-1βlevels were detected by enzyme-linked immunosorbent assay(ELISA)before and after treatment.Changes of hemorheological indexes(whole blood viscosity,whole blood low tangential viscosity and fibrinogen)of ACI patients were detected by SA-6600 automatic hemorheometer before and after treatment.The occurrence of adverse reactions during treatment was recorded.The modified Rankin Scale(mRS)was used to evaluate the clinical outcome at 90 days of onset,and the Barthel index was used to evaluate the living ability of the patients before and after treatment.Results The total clinical effective rate of ACI patients was higher in the combined group than that in the western medicine group(89.66%vs.74.14%,P<0.05).After treatment,the levels of MIF,whole blood viscosity,whole blood low shear viscosity,fibrinogen,IL-6 and IL-1βwere lower in 2 groups than those before treatment,and those were lower in the combined group than those in the western medicine group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).The Barthel index was higher after treatment in the two groups,and which was higher in the combined group than that of the western medicine group(P<0.05).The good outcome rate was higher in the combination group than that of the western medicine group(51.72%vs.32.76%,P<0.05).Conclusion Salvia miltiorrhiza polyphen

关 键 词：脑梗死 替罗非班 巨噬细胞游走抑制因子 血液流变学 注射用丹参多酚酸盐 

分 类 号：R285.6[医药卫生—中药学] R743.33[医药卫生—中医学]