Objective To evaluate the clinical efficacy of Butylphthalide combined with fibrinolytic enzyme in the treatment of acute cerebral infarction. Methods A total of 60 elderly patients with acute cerebral infarction who had missed the opportunity of thrombolytic therapy were enrolled in this study from January 2014 to December 2016 at Zhengzhou University Second Affiliated Hospital.Patients were randomly divided into an observation group(n= 30)and a control group(n= 30).Patients in the control group were treated with fibrinolytic enzyme alone,and those in the observation group received Butylphthalide combined with fibrinolytic enzyme.Peak flow velocity and mean flow velocity of the middle cerebral artery were analyzed and compared between the two groups before and after treatment.Data on clinical safety,efficacy,the national institutes of health stroke scale(NIHSS)and the Barthel score were also compared between the two groups. Results After treatment,the peak velocity 〔(74.60 ± 4.31)cm/s vs.(69.19 ± 3.36)cm/s〕 and average velocity 〔(38.71 ± 2.29)cm/s vs.(34.01 ± 2.01)cm/s〕 of the middle cerebral artery were significantly increased in the treatment group compared with those in the observation group (both P< 0.05).Meanwhile,the clinical efficacy was significantly higher in the observation group (96.7% vs.73.3%,P< 0.05).Moreover,NIHSS scores 〔(5.91 ± 3.51)vs.(8.31 ± 3.09)〕and Barthel scores 〔(71.29 ± 3.81)vs.(53.60 ± 4.33)〕 were significantly improved in the treatment group compared with those in the observation group(both P< 0.05).In addition,there were no obvious adverse reactions during treatment in the two groups. Conclusions Butylphthalide combined with plasmin can safely and effectively improve cerebral hemodynamics and prognosis in patients with acute cerebral infarction.%目的 评估丁苯酞联合纤溶酶治疗急性脑梗死患者的临床疗效. 方法 本研究共纳入2014年1月至2016年12月在我院治疗的失去溶栓治疗机会的老年急性脑梗死患者60例为研究对象,采用随机数字法将其分为观察组(30例)和对照组(30例).对照组给予单纯纤溶酶,观察组采用丁苯酞联合纤溶酶治疗,分析和比较两组患者治疗前后大脑中动脉的峰流速、平均流速,比较两组患者的临床疗效、神经功能缺损评分、日常生活能力评分、不良反应和用药安全性指标. 结果 治疗后,观察组患者大脑中动脉的峰流速和平均流速明显优于对照组,分别为〔(74.60 ± 4.31)cm/s、(69.19 ± 3.36)cm/s)〕和〔(38.71 ± 2.29)cm/s、(34.01 ± 2.01)cm/s〕(均 P< 0.05).观察组的临床疗效为(96.7%)高于对照组(73.3%)(P<0.05).治疗后,观察组患者神经功能缺损评分(5.91 ± 3.51)分和日常生活能力评分(71.29 ± 3.81)分明显优于对照组,分别为(8.31 ± 3.09)分和(53.60 ± 4.33)分(均 P<0.05).另外,两组的用药安全性指标均在正常范围内,治疗期间均未发生明显不良反应. 结论 丁苯酞联合纤溶酶治疗急性脑梗死患者安全有效,能够更加有效的改善脑部血流动力学、提高临床治疗效果.
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