Salvianolic Acid for Injection for treatment of acute cerebral infarction: efficacy, safety, and impact on serum levels of inflammatory factors

Abstract

Objective To observe the efficacy and safety of Salvianolic Acid for Injection in patients with acute cerebral infarction as well as its impact on serum levels of inflammatory factors, in order to explore new targets and new directions for drug intervention. Methods A prospective study was conducted to analyze 153 patients with acute cerebral infarction admitted to the Department of Neurology of the Second Hospital of Shanxi Medical University from February 2017 to March 2018. The patients were divided into either a control group (n=83) or an observation group (n=70). Both groups were treated with conventional drugs, and the observation group was additionally given Salvianolic Acid for Injection. Both groups were treated for 14 days. The neurological deficit (NIHSS scores) and inflammatory factor (sCD40L and C-reactive protein [CRP]) levels were compared between the two groups. The occurrence of adverse reactions during medications was recorded. The modified Rankin scale (mRS) scores at the 90-day follow-up were also recorded. Stepwise multivariate logistic regression was used to analyze the independent factors for good prognosis of patients with acute cerebral infarction at 90 days of discharge. Results After 14 days of treatment, the NIHSS score of the observation group was significantly lower than that of the control group, and the improvement rate of NIHSS score was significantly more obvious in the observation group [(2.33±1.45) vs (3.19±3.11), F=2.436, P=0.032; (0.56±0.32) vs (0.33±0.36), t=3.536, P=0.001]. At the 90-day follow-up, the mRS score of the observation group was significantly lower and the proportion of patients with a good prognosis was significantly higher than those of the control group [(0.78±1.17) vs (1.31±1.42), t=-2.522, P=0.013; 55.7%(39/70) vs 54.2%(45/83), χ2=7.021, P=0.008]. Using good prognosis as a dependent variable and including its possible influencing factors as independent variables, stepwise multivariate logistic regression analysis showed that the use of Salvianolic Acid for Injection and the improvement of neurological function were independent predictors of good prognosis in acute ischemic stroke patients at 90 days. There were no significant differences in liver function, renal function, or myocardial enzyme related test indexes between the two groups after 14 days of treatment (P>0.05). After 14 days of treatment, the levels of sCD40L were significantly lower than those before treatment in both groups [(352.06±150.69) pg/ml vs (522.63±226) pg/ml, F=2.258, P=0.001; (372.24±135.77) pg/ml vs (554.78±179.86) pg/ml, F=2.228, P=0.001]. Although the sCD40L level was lower in the observation group than in the control group after 14 days of treatment, the difference was not statistically significant (F=0.974, P=0.385). After 14 days of treatment, the CRP level of the observation group was significantly lower than that of the control group, and the degree of CRP decrease was significantly more obvious in the observation group [(2.96±1.83) mg/L vs (3.90±3.29) mg/L, F=2.045, P=0.003; (2.57±2.41) mg/L vs (1.68±1.15) mg/L, t=3.453, P=0.028]. Conclusion Salvianolic Acid for Injection can promote the recovery of neurological function, improve clinical prognosis in patients with acute cerebral infarction, and effectively reduce the level of inflammatory factors. Key words: Cerebral infarction; Salvianolic Acid for Injection; Inflammatory factor; Effectiveness; Safety