Objective:To investigate the effect of citicoline combined with butylphthalide in patients with acute cerebral infarc-tion(ACI),and to explore the possible mechanism.Methods:A total of 150 patients with ACI were divided into control group and ob-servation group according to the different treatment options received,with 75 cases in each group.The patients in the control group was treated with butylphthalide,and patients in the observation group was treated with citicoline combined with butylphthalide.Both groups were treated for 14 days.The National Institutes of Health Stroke Scale(NIHSS),Barthel index(BI)and modified Rankin score(mRS)were used to evaluate the patients.The cerebral blood flow velocity[blood flow velocity of anterior cerebral artery(AC A)and middle cerebral artery(MCA)]was measured,and the serum neuron-specific enolase(NSE),brain-derived neurotrophic factor(BD-NF),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured.The indexes and curative effects of the two groups were compared.Results:The total effective rate of clinical efficacy in the observation group was higher than that in the control group(93.33％vs.78.67％,P＜0.05).After treatment,the NIHSS score and mRS score of patients in the observation group were lower than those of the control group(P＜0.05),and the BI score and blood flow velocity of AC A and MCA were higher than those of the control group(P＜0.05).Compared with the control group,the levels of serum NSE,TNF-α and IL-6 of patients in the observation group were lower(P＜0.05),and the level of BDNF was higher(P＜0.05).Conclusion:The treatment of ACI patients with citicoline combined with butylphthalide can achieve better curative effect,and the related mechanism may be related to the regulation of serum NSE and BD-NF levels and the reduction of inflammation.