Effect of butylphthalide combined with edaravone on cerebral hemodynamics, vascular endothelial function and cytokines in elderly patients with acute cerebral infarction

Abstract

Objective To investigate the effects of butylphthalide combined with edaravone on cerebral hemodynamics, vascular endothelial function and cytokines in elderly patients with acute cerebral infarction. Methods From May 2017 to May 2018, 82 elderly patients with acute cerebral infarction admitted to the First People's Hospital of Wenling were selected and randomly divided into two groups according to the digital table, with 41 cases in each group.The patients in the control group were treated with edaravone, while the patients in the treatment group were treated with butylphthalide on the basis of the control group.The two groups were treated for 2 weeks.The neurological deficit scale (NIHSS), cerebral hemodynamics, vascular endothelial function and cytokines were compared between the two groups before and after treatment. Results The NIHSS score of the treatment group was (18.49±1.87)points, which was lower than (22.17±1.32)points of the control group at 2 weeks after treatment (t=10.294, P<0.05). The mean flow velocity [(31.70±3.25)cm/s], vascular resistance index (0.79±0.12) and maximum peak flow velocity [(54.21±2.65)cm/s] in the treatment group were higher than those in the control group [(26.91±4.39)cm/s, (0.61±0.05) and (43.76±3.10)cm/s] (t=5.615, 8.866, 16.407, all P<0.05). The contents of NO [(71.27±6.58)μmol/L] and eNOS [(66.37±3.65)U/mL] in the treatment group were higher than those in the control group [(62.30±2.71)μmol/L and (57.89±4.08)U/mL] (t=8.071, 9.919, all P<0.05). After 2 weeks of treatment, the contents of IL-6 [(27.36±2.71)pg/mL], CRP [(2.87±0.76)mg/L] and TNF- α[(98.24±10.48)ng/mL] in the treatment group were lower than those in the control group [(43.25±4.10)pg/mL, (4.59±0.91)mg/L and (160.27±15.42)ng/mL] (t=20.702, 9.289, 21.303, all P<0.05). The total effective rate of treatment group (90.24%) was higher than that of control group (68.29%) (χ2=6.011, P<0.05). Conclusion Butylphthalide combined with edaravone can improve cerebral hemodynamics, vascular endothelial function and alleviate cellular inflammatory reaction in elderly patients with acute cerebral infarction, and the curative effect is significant, which is worthy of clinical study. Key words: Infarction, middle cerebral artery; Vascular resistance; Blood flow velocity; Nitric oxide; Nitric oxide synthase; Interleukin-6; Tumor necrosis factor-alpha; Butylphthalide; Edaravone; Aged