【摘要】 目的：观察丁苯酞联合注射用重组人TNK组织型纤溶酶原激活剂（rhTNK-tPA）治疗急性脑梗死（ACI）患者的效果。方法：回顾性分析2021年7月至2023年8月该院收治的92例ACI患者的临床资料，按照治疗方案不同将其分为观察组与对照组各46例。对照组采用rhTNK-tPA治疗，观察组在对照组基础上联合丁苯酞治疗。比较两组临床疗效，治疗前后凝血功能指标[D-二聚体（D-D）、纤维蛋白原（FIB）、凝血酶原时间（PT）、凝血酶时间（TT）]水平、半乳糖凝集素-1(Gal-1)水平、半乳糖凝集素-3(Gal-3)水平、神经功能缺损程度[美国国立卫生研究院卒中量表（NIHSS）]评分和日常生活活动能力[Barthel指数（BI）]评分，以及不良反应发生率。结果：观察组治疗总有效率为97.83%(45/46)，高于对照组的80.43%(37/46)，差异有统计学意义（P<0.05）。治疗14 d后，两组FIB、D-D水平均低于治疗前、治疗7 d后，且观察组低于对照组；两组PT、TT水平均高于治疗前、治疗7 d后，且观察组高于对照组，差异有统计学意义（P<0.05）。治疗14 d后，两组Gal-1、Gal-3水平均低于治疗前、治疗7 d后，且观察组低于对照组，差异有统计学意义（P<0.05）。治疗14 d后，两组NIHSS评分均低于治疗前、治疗7 d后，且观察组低于对照组；治疗3个月后，两组BI评分均高于治疗前、治疗1个月后，且观察组高于对照组，差异有统计学意义（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：丁苯酞联合rhTNK-tPA治疗ACI患者可提高治疗总有效率和日常生活活动能力评分，改善凝血功能指标水平，以及降低半乳糖凝集素-1、半乳糖凝集素-3水平和神经功能缺损程度评分，效果优于单纯rhTNK-tPA治疗。更多还原

【Abstract】 Objective: To observe effects of Butylphthalide combined with recombinant human TNK tissue plasminogen activator(rhTNK-tPA) in treatment of patients with acute cerebral infarction(ACI). Methods: The clinical data of 92 patients with ACI admitted to the hospital from July 2021 to August 2023 were retrospectively analyzed. According to different treatment regimens, they were divided into observation group and control group, 46 cases in each group. The control group was treated with rhTNK-tPA, while the observation group was treated with Butylphthalide on the basis of that of the control group. The clinical efficacy, the levels of coagulation function indexes [D-dimer(D-D), fibrinogen(FIB), prothrombin time(PT), thrombin time(TT)], galectin-1(Gal-1) and galectin-3(Gal-3), the neurological deficit degree [National Institutes of Health stroke scale(NIHSS)] and activities of daily living [Barthel index(BI)] scores, and the incidence of adverse reactions were compared between the two groups before and after the treatment. Results: The total effective rate of the observation group was 97.83%(45/46), which was higher than 80.43%(37/46) of the control group, and the difference was statistically significant(P<0.05). After 14 days of treatment, the levels of FIB and D-D in the two groups were lower than those before the treatment and after 7 days of treatment, and those in the observation group were lower than those in the control group; the levels of PT and TT in the two groups were higher than those before the treatment and after 7 days of treatment, and those in the observation group were higher than those in the control group; and the differences were statistically significant(P<0.05). After 14 days of treatment, the levels of Gal-1 and Gal-3 in the two groups were lower than those before the treatment and after 7 days of treatment, those in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). After 14 days of treatment, the NIHSS scores of the two groups were lower than those before the treatment and after 7 days of treatment, and that in the observation group was lower than that in the control group; after 3 months of treatment, the BI scores of the two groups were higher than those before the treatment and after 1 month of treatment, and that in the observation group was higher than that in the control group; and the differences were statistically significant(P<0.05). However, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions: Butylphthalide combined with rhTNK-tPA in the treatment of the ACI patients can improve the total effective rate of treatment and the activities of daily living scores, improve the levels of coagulation function indexes, and reduce the levels of galectin-1, galectin-3 and the neurological deficit scores. Moreover, it is superior to simple rhTNK-tPA treatment.更多还原