Sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of acute cerebral infarction.

Xuewen Wo,Jiajia Wang,Jinyan Han,Xiaoying Liu,Zhonggong Wang,Xinmin Wang

doi:10.12669/pjms.36.4.1831

Abstract

Objective:To observe the clinical efficacy of sequential butylphthalide therapy combined with dual antiplatelet therapy in the treatment of elderly patients with acute cerebral infarction (ACI).Methods:One hundred and twenty-two elderly patients with ACI who were admitted to the department of neurology of our hospital at May 2016-August 2018 were selected grouped into a control group and an observation group by random number table method, 61 in each group. On the basis of conventional treatment, the patients in the control group were given dual antiplatelet therapy (aspirin enteric-coated tablets + clopidogrel bisulfate tablets), while the patients in the observation group were given sequential butylphthalide therapy on the basis of the control group. The clinical effects of the two groups were compared after four weeks of treatment, and the changes of National Institutes of Health Stroke Scale (NIHSS), ADL score, plasma 3-mercaptopyruvate sulphurtransferase (3-MST) and Amyloid β42 (Aβ42) levels and the occurrence of adverse reactions during treatment were recorded.Results:The clinical efficacy of the observation group was better than that of the control group (P<0.05). There was no significant difference in NIHSS and ADL scores between the two groups before treatment (P>0.05). After treatment, the NIHSS and ADL scores of the observation group were better than those of the control group (P<0.05). There was no significant difference in plasma levels of 3-MST and AB42 between the two groups before treatment (P>0.05). The level of plasma 3-MST in the observation group was higher than that in the control group, and the level of plasma Aβ42 was lower than that in the control group (P<0.05). No serious adverse reactions occurred during the treatment period in both groups.Conclusion:Butylphthalide sequential therapy combined with dual antiplatelet therapy is effective in the treatment of elderly ACI. It can effectively improve the plasma level of 3-MST and decrease the plasma level of Aβ42, which is conducive to improving the living ability and neurological function of patients and has high safety.

Highlights

Acute cerebral infarction (ACI) is a common neurological disease
There was significant difference between the two groups (P0.05)
There were no significant differences in plasma levels of 3-mercaptopyruvate sulphurtransferase (3-MST) and Amyloid β42 (Aβ42) between the two groups before treatment (P>0.05)

Summary

Introduction

Acute cerebral infarction (ACI) is a common neurological disease. The incidence of ACI has been increasing in recent years.[1]. In recent years, with the change of people’s lifestyle, the etiology of ACI is complex and diverse, and the effect of conventional treatment is poor.[6,7] At present, thrombolysis and anti-platelet aggregation are commonly used in the treatment of ACI patients, and promoting the recovery of patients’ nervous function is one of the key points in the treatment of ACI.[8,9] Aspirin combined with clopidogrel is the standard dual antiplatelet therapy scheme for ACI patients.[10] Butylphthalide is the ACI treatment drug recommended by the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke (2014).[11] The latest research suggests that butylphthalide can significantly improve the neurological deficits of patients and improve their living ability.[12]

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Discussion

Conclusion