Therapeutic effect of alteplase combined with butylphthalide on patients with acute cerebral infarction

Abstract

Objective To evaluate the efficacy of alteplase combined with butylphthalide on acute cerebral infarction (ACI) and its effects on homocysteineHcy(Hcy), cognitive function and neurological function. Methods A total of 162 patients with ACI who were treated at neurology in Jiaozhou People’s Hospital from March 2017 to February 2018 were selected. The patients were divided into treatment group and control group according to the drugs used by patients, with 81 cases in each group. All ACI patients were given routine treatment, the patients in the control group received 0.9 mg/kg of alteplase injection, and the patients in the treatment group were given 0.2 g of butylphthalide soft capsules on the basis of the control method of the control group, 3 times a day. All patients were treated for 28 days. The laboratory parameters between the two groups were compared before and after treatment, including Hcy, 6-keto-prostaglandin-F1a (6-k-PGF1a) and neuron-specific enolase (NSE). The cognitive function and neurological deficits were evaluated by mini-mental state examination score (MMSE) and the National Institutes of Health Stroke Scale score(NIHSS) before and 3 d, 7 d, 14 d and 24 d after treatment. The clinical efficacy and incidence of adverse reactions were compared between the two groups. Results The 6-k-PGF1a, NSE and Hcy indexes of the two groups were significantly improved after treatment (P<0.05). The 6-k-PGF1a, NSE and Hcy indexes of the treatment group improved more significantly after treatment than those in the control group(P<0.05). The MMSE scores and NIHSS scores of the two groups were significantly improved on the 3rd, 7th, 14th and 28th day after treatment compared with before treatment (P<0.05). The MMSE scores and NIHSS scores of the treatment group on the 3rd, 7th, 14th and 28th day after treatment improved more significantly than those in the control group (P<0.05). Compared with the control group, the total effective rate of the treatment group was significantly higher(92.6% vs. 71.6%, χ2=12.138, P<0.01). Conclusions Alteplase combined with butylphthalide in treatment of patients with ACI, can significantly improve the cognitive impairment and neurological deficits, reduce the serum NSE and Hcy, increase the 6-k-PGF1a, and the clinical efficacy and safety are high. Key words: Acute cerebral infarction; Butylphthalide; Alteplase; Therapeutic effect