Effect of dl-3n-Butylphthalide on cerebral blood perfusion and neurological function in patients with acute cerebral infarction

doi:10.11817/j.issn.1673-9248.2020.04.007

Abstract

Abstract:

Objective

To investigate the effect of dl-3n-butylphthalide on the cerebral blood perfusion and neurological function in patients with acute cerebral infarction.

Methods

A total of 94 patients who were hospitalized in the Department of Neurology of First Affiliated Hospital of Xinxiang Medical College from April 2018 to January 2020 were prospectively included in strict accordance with the inclusion and exclusion criteria. The patients were randomly divided into the intervention group (n=47) and the control group (n=47). The control group was treated according to the standard diagnosis and treatment of acute cerebral infarction, while the intervention group was treated with dl-3n-butylphthalide sodium chloride injection on the basis of standard diagnosis and treatment. Both groups were treated continuously for 2 weeks. The perfusion parameters of brain CT were observed before and 6 months after treatment, including regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), transit time to the peak (TTP), and mean transit time (MTT). The changes of National Institutes of Health stroke scale (NIHSS) scores and activities of daily living (ADL) scores were also recorded at diagnosis and 6 months after treatment. Independent sample t test was used to compare the age, baseline blood pressure, blood lipid, fasting blood glucose, onset time, brain CT perfusion parameters (rCBF, rCBV, TTP, MTT), NIHSS score, and ADL score, between the two groups.

Results

After treatment, rCBF of the intervention group was higher than that of the control group [(36.16±6.65)ml/(100 g·min) vs (32.87±8.48)ml/(100 g·min), t=2.091, P=0.039], and rCBV was higher than that of the control group [(2.83±0.92)ml/100 g vs (2.42±0.81)ml/100 g, t=2.317, P=0.023], MTT of the intervention group decreased than that of the control group [(3.71±1.10)s vs (4.34±0.96)s, t=-2.981, P=0.004], and tTTP of the intervention group decreased than that in the control group [(14.90±4.30)s vs (16.49±2.12)s, t=-2.269, P=0.026]; after treatment, NIHSS score of the intervention group was lower than that of the control group [(5.57±3.07) vs (7.00±3.68), t=-2.038, P=0.044], and the ADL score was higher than that of the control group [(61.06±17.51) vs (49.68±15.51), t=3.336, P=0.001].

Conclusion

Dl-3n-butylphthalide treatment can improve the regional blood flow perfusion level of patients with cerebral infarction, promote the recovery of neurological function, and is beneficial in the clinical treatment of acute cerebral infarction.

Key words: Dl-3n-butylphthalide, Cerebral infarction, acute, Cerebral blood perfusion, National Institutes of Health stroke scale, Activities of daily living scale

Jinxiu Wu, Qing Li, Chaowei Wang, Zhixiu Xu, Panpan Zhao, Lijun Zhang, Bin Yuan, Jianhua Zhao, Sibei Ji. Effect of dl-3n-Butylphthalide on cerebral blood perfusion and neurological function in patients with acute cerebral infarction[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2020, 14(04): 221-225.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.11817/j.issn.1673-9248.2020.04.007

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2020/V14/I04/221

Figures/Tables 3

临床资料	试验组（47例）	对照组（47例）	统计值	P值
性别[例（%）]	31（65.96）	28（59.57）	χ²=0.410	0.522
高血压病史[例（%）]	26（55.32）	25（53.19）	χ²=0.043	0.836
糖尿病史[例（%）]	12（25.53）	13（27.66）	χ²=0.054	0.815
吸烟史[例（%）]	23（48.94）	16（34.04）	χ²=2.147	0.143
饮酒史[例（%）]	18（38.30）	16（34.04）	χ²=0.184	0.668
高同型半胱氨酸血症史[例（%）]	22（46.81）	28（59.57）	χ²=1.538	0.215
年龄（岁， $x ˉ ± s$ ）	56.74±12.11	60.64±9.88	t=1.708	0.091
收缩压（mmHg， $x ˉ ± s$ ）	137.36±16.05	135.26±17.26	t=0.613	0.542
舒张压（mmHg， $x ˉ ± s$ ）	84.49±10.58	85.06±14.67	t=0.218	0.828
总胆固醇（mmol/L， $x ˉ ± s$ ）	3.84±1.07	4.12±1.41	t=1.079	0.283
三酰甘油（mmol/L， $x ˉ ± s$ ）	1.12±0.38	1.13±0.39	t=0.138	0.891
高密度脂蛋白（mmol/L， $x ˉ ± s$ ）	1.07±0.23	1.08±0.29	t=0.291	0.772
低密度脂蛋白（mmol/L， $x ˉ ± s$ ）	2.09±0.84	2.19±0.88	t=0.569	0.571
空腹血糖（mmol/L， $x ˉ ± s$ ）	5.49±1.52	5.16±1.12	t=1.186	0.239
发病时间（h， $x ˉ ± s$ ）	13.71±8.65	12.88±8.49	t=0.469	0.640
基线NIHSS评分（分， $x ˉ ± s$ ）	9.21±3.82	8.32±4.20	t=1.080	0.283

临床资料	试验组（47例）	对照组（47例）	统计值	P值
性别[例（%）]	31（65.96）	28（59.57）	χ²=0.410	0.522
高血压病史[例（%）]	26（55.32）	25（53.19）	χ²=0.043	0.836
糖尿病史[例（%）]	12（25.53）	13（27.66）	χ²=0.054	0.815
吸烟史[例（%）]	23（48.94）	16（34.04）	χ²=2.147	0.143
饮酒史[例（%）]	18（38.30）	16（34.04）	χ²=0.184	0.668
高同型半胱氨酸血症史[例（%）]	22（46.81）	28（59.57）	χ²=1.538	0.215
年龄（岁， $x ˉ ± s$ ）	56.74±12.11	60.64±9.88	t=1.708	0.091
收缩压（mmHg， $x ˉ ± s$ ）	137.36±16.05	135.26±17.26	t=0.613	0.542
舒张压（mmHg， $x ˉ ± s$ ）	84.49±10.58	85.06±14.67	t=0.218	0.828
总胆固醇（mmol/L， $x ˉ ± s$ ）	3.84±1.07	4.12±1.41	t=1.079	0.283
三酰甘油（mmol/L， $x ˉ ± s$ ）	1.12±0.38	1.13±0.39	t=0.138	0.891
高密度脂蛋白（mmol/L， $x ˉ ± s$ ）	1.07±0.23	1.08±0.29	t=0.291	0.772
低密度脂蛋白（mmol/L， $x ˉ ± s$ ）	2.09±0.84	2.19±0.88	t=0.569	0.571
空腹血糖（mmol/L， $x ˉ ± s$ ）	5.49±1.52	5.16±1.12	t=1.186	0.239
发病时间（h， $x ˉ ± s$ ）	13.71±8.65	12.88±8.49	t=0.469	0.640
基线NIHSS评分（分， $x ˉ ± s$ ）	9.21±3.82	8.32±4.20	t=1.080	0.283

组别	例数	时间	rCBF（ml/100 g·min）	rCBV（ml/100 g）	TTP（s）	MTT（s）
对照组	47	治疗前	31.96±8.78	2.46±0.88	17.38±2.14	4.64±1.03
		治疗后	32.87±8.48	2.42±0.81	16.49±2.12	4.34±0.96
试验组	47	治疗前	29.47±6.68	2.54±0.87	18.74±4.38	4.98±1.06
		治疗后	36.16±6.65	2.83±0.92	14.90±4.30	3.71±1.10
t值^a			2.091	2.317	-2.269	-2.981
P值^a			0.039	0.023	0.026	0.004
t值^b			-2.511	0.611	5.612	4.431
P值^b			0.016	0.544	<0.001	<0.001
t值^c			-19.611	-4.197	16.184	14.549
P值^c			<0.001	<0.001	<0.001	<0.001

组别	例数	时间	NIHSS评分	ADL评分
对照组	47	治疗前	8.32±4.20	47.45±15.56
		治疗后	7.00±3.68	49.68±15.51
试验组	47	治疗前	9.21±3.82	50.43±15.35
		治疗后	5.57±3.07	61.06±17.51
t值^a			-2.038	3.336
P值^a			0.044	0.001
t值^b			-2.029	-1.470
P值^b			0.048	0.148
t值^c			6.301	-9.737
P值^c			<0.001	<0.001

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