目的 探讨复方丹参滴丸联合阿托伐他汀治疗对伴有颈动脉粥样硬化短暂性脑缺血发作患者脑循环动力的影响。方法 将2017年12月—2018年12我院收治入院的98例伴有颈动脉粥样硬化短暂性脑缺血发作患者为研究对象,随机分为观察组(49例,给予复方丹参滴丸联合阿托伐他汀治疗)和对照组(49例,给予阿托伐他汀治疗)。观察对比治疗前及治疗后2组患者每日短暂性脑缺血发作频率及持续时间,血脂水平、血流变指标、粥样硬化斑块及斑块面积。结果 治疗前,两组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比,差异无统计学意义(P>0.05);治疗后,2组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比均有所改善,其中观察组患者每日短暂性脑缺血发作频率、持续时间、各项血脂水平、脑循环动力学指标IMT 及斑块面积相比优于对照组,差异有统计学意义(P<0.05)。结论 在伴有颈动脉粥样硬化短暂性脑缺血发作患者中采用复方丹参滴丸联合阿托伐他汀治疗效果确切,可有效降低伴有颈动脉粥样硬化的短暂性脑缺血发作患者发作频率及持续时间,同时可有效调节患者血脂水平,改善对脑循环动力学指标,值得临床推广普及。

Objective To investigate the effect of compound Danshen dripping pills combined with atorvastatin on cerebral circulation dynamics in patients with transient ischemic attack accompanied by carotid atherosclerosis. Methods A total of 98 patients with transient ischemic attack with carotid atherosclerosis admitted to our hospital from December 2017 to December 2018 were randomly divided into observation group (49 cases, receiving compound danshen drop pill combined with atorvastatin) and control group (49 cases, receiving atorvastatin), to observe and compare the frequency and duration of transient ischemic attack, blood lipid level, hemorheological indexes, atherosclerotic plaque and plaque area of the two groups before and after treatment. Results Before treatment, there was no significant difference in frequency, duration, blood lipid levels, IMT and plaque area between the two groups (P>0.05). After treatment, 2 groups of patients with transient ischemic attack daily frequency, duration, the lipid levels and cerebral circulation dynamics index IMT and plaque area were improved. Compared with observation group of patients with transient ischemic attack daily frequency, duration, the lipid levels and cerebral circulation dynamics index IMT and plaque area were better than control group, the differences were statistical significance (P<0.05). Conclusion Patients in associated with carotid atherosclerosis with transient ischemic attack using compound danshen dropping pill with atorvastatin therapy have good effects. This may effectively reduce frequency and duration in patients with transient ischemic attack associated with carotid atherosclerosis, regulate blood lipid levels at the same time, and improve the dynamics of cerebral circulation index. It is worthy of clinical popularization.

       目的   评价血塞通联合右美托咪定对脑缺血再灌注损伤大鼠的脑保护效果。方法   选择老龄雄性Wistar大鼠50只，随机分为假手术（C）组、脑缺血再灌注（R）组、血塞通（P）组、右美托咪定（D）组，血塞通联合右美托咪定（PD）组，每组各10只。根据组别给予不同药物，行神经行为学测试；于第3、7天，测量脑梗死面积、脑水含量，以及超氧化物歧化酶（Superoxide dismutase，SOD）、谷胱甘肽过氧化酶（Glutathione peroxidase，GSH-PX）活性测定。结果   给药后第3、5、7天，与P、D组相比，PD组神经行为学评分改善更加显著（P＜0.001）；给药后第3、7天，与P组相比，PD组脑梗死面积、脑水含量均降低（P=0.01，P=0.002），SOD、GSH-PX活性升高显著（P=0.03，P=0.001）；与D组相比，PD组脑梗死面积、脑水含量也显著降低（P＜0.01，P=0.008）；SOD、GSH-PX活性升高显著（P=0.009，P＜0.001）。结论   血塞通联合右美托咪定较单独应用药物，能显著减轻缺血再灌注损伤造成的脑损害，具有脑保护作用。

       Objective  To explore the effects of Xuesaitong combined with dexmedetomidine on cerebral ischemia-reperfusion in elderly rats．Methods  Fifty elderly male Wistar rats were randomly divided into 5 groups：sham operation（C）group，cerebral ischemia-reperfusion（R）group，Xuesaitong（P）group，dexmedetomidine（D）group，Xuesaitong combined with dexmedetomidine（PD）group．Xuesaitong was given in group P，dexmedetomidine was given in group D，and normal saline was given in group C and group R，continuously for 7 days．After 3- and 7-day treatment，the brain of rats was dissected out to assay the area of cerebral infarction，degree of cerebral edema，superoxide dismutase（SOD） and glutathione peroxidase（GSH-PX） activity．Results  When compared PD group with P and D group，neurobehavioral score was lower at 3，5，7 day（P＜0.001）；area of cerebral infarction，degree of cerebral edema were less（P=0.01，P=0.002），activity of SOD and GSH-PX were higher at 3，7 days（P=0.03，P=0.001）respectively．When compared PD group with D group，area of cerebral infarction，degree of cerebral edema were less（P＜0.01，P=0.008），activity of SOD and GSH-PX were higher at 3，7 days（P=0.009，P＜0.001）respectively．Conclusions  The combination of Xuesaitong and dexmedetomidine can obviously reduce the damage by cerebral ischemia-reperfusion in elderly rats and has brain protective effects．