Objective To observe the efficacy and safety of salvianolic acid for injection combined with urinary kallidinogenase in the treatment of acute cerebral infarction (ACI) patients with blood stasis obstructing collateral pattern. Methods A total of 77 ACI patients with blood stasis obstructing collateral pattern were enrolled as research subjects and randomly divided into the western medicine group (n=39) or the combination group (n=38) with a random number table method. Both groups received conventional treatment, the western medicine group was given intravenous infusion of urinary kallidinogenase, while the combination group received intravenous infusion of urinary kallidinogenase and salvianolic acid, and the treatment course was 2 weeks for both groups. The clinical efficacy was compared between the two groups. The degrees of neurological deficit (National Institutes of Health Stroke Scale [NIHSS] score), cognitive function (Montreal Cognitive Assessment [MoCA] score), and activities of daily living (modified Barthel index [mBI]), as well as hemorheological indexes (plasma viscosity, plasma fibrinogen [FIB], high-shear whole blood viscosity, low-shear whole blood viscosity) and serum levels of factors related to nerve injury, vascular inflammation, and nerve repair (S100 calcium-binding protein B [S100β], neuron-specific enolase [NSE], glial fibrillary acidic protein [GFAP], high-sensitivity C-reactive protein [hs-CRP], lipoprotein-associated phospholipase A2 [Lp-PLA2], and brain-derived neurotrophic factor [BDNF]) levels were also compared before and after treatment. Adverse reactions were recorded. Results After 2 weeks of treatment, the total therapeutic effective rate of the combination group was 94.74%, which was higher than the 79.49% of the western medicine group (P<0.05). Before treatment, there was no statistically significant difference between the two groups in NIHSS score, MoCA score, mBI score, plasma viscosity, plasma FIB level, and high/low-shear whole blood viscosity, as well as serum levels of S100β, NSE, BDNF, hs-CRP, GFAP, and Lp-PLA2 (all P>0.05). Two weeks after treatment, the mBI, MoCA score, and serum BDNF level in the combination group were higher than those in the western medicine group, while the NIHSS score, high/low-shear whole blood viscosity, plasma viscosity, plasma FIB level, and serum levels of S100β, NSE, GFAP, hs-CRP, and Lp-PLA2 were lower than those in the western medicine group (all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups during treatment (P>0.05). Conclusion Salvianolic acid for injection combined with urinary kallidinogenase has significant efficacy in the treatment of ACI with blood stasis obstructing collateral pattern, and it can effectively improve neurological function, cognitive function, and activities of daily living, reduce blood viscosity, alleviate nerve injury and vascular inflammation, promote nerve repair, and shows good safety.

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