ABSTRACT
OBJECTIVE: To investigate the effects of Xuesaitong for injection on microembolic signal (MES) and blood lipid of patients with middle cerebral artery (MCA) atherosclerotic stenosis complicated with MES positive transient ischemic attack (TIA). METHODS: A total of 98 patients with MCA atherosclerotic stenosis complicated with MES positive TIA in the Affiliated Hospital of Chengdu University of TCM during May 2015-May 2016 were divided into routine group and Xuesaitong group according to random numble table, with 49 cases in each group. Routine group received routine treatment. Xuesaitong group was additionally given Xuesaitong for injection (lyophilized) 400 mg intravenously, once a day, for consecutive 15 d, on the basis of routine treatment. The distribution of MES classification and the number of MES were observed in 2 groups before treatment, 15 d after treatment and 3rd and 6th month after treatment. The levels of TG, TC, LDL were observed before treatment and 15 d after treatment. The occurrence of ischemia event and ADR were recorded. RESULTS: Fifteen days after treatment, the distribution of MES classification in 2 groups was significantly better than before treatment; Xuesaitong group was significantly better than routine group, with statistical significance (P＜0. 05). At 3rd and 6th month after treatment, the distribution of MES classification in Xuesaitong group was significantly better than routine group; 6th month after treatment was significantly better than 3rd month after treatment, with statistical significance (P＜0. 05). Fifteen days and the 3rd, 6th month after treatment, the number of MES in 2 groups were significantly lower than before treatment and decreased as time; Xuesaitong group was significantly lower than routine group, with statistical significance (P＜0. 05). Fifteen days after treatment, TG and TC levels of 2 groups were significantly lower than before treatment; Xuesaitong group was significantly lower than routine group, with statistical significance (P＜0. 05); there was no statistical significance in the level of LDL before and after treatment (P＞0. 05). The incidence of ischemic events in routine group at 6th month after treatment was significantly higher than 3rd month after treatment, and the incidence of ischemic events in Xuesaitong group at 3rd and 6th month after treatment was significantly lower than routine group, with statistical significance (P＜0. 05). At 6th month after treatment, the incidence of ADR in 2 groups was significantly lower than 3rd month, with statistical significance (P＜0. 05). CONCLUSIONS: Based on routine treatment, Xuesaitong for injection can reduce the number of MES, reduce the incidence of ischemia events and further improve the level of blood lipid in patients with MCA atherosclerotic stenosis complicated with MES positive TIA without increasing the occurrence of ADR.
ABSTRACT
Objective To investigate the relation between microembolic signals (MES) and vertebral basilar artery ste?nosis in patients with brainstem infarction. Methods A total of 156 patients with acute brainstem infarction, who were de?termined the cerebral infarction lesion and vertebral basilar artery stenosis by cranial magnetic resonance imaging and CT an?giography, and were monitored by transcranial Doppler via occipital window of basilar arterial MES monitoring in 7 days of the onset, were divided into microembolus signal negative group (n=136) and positive group (n=20). The clinical data were compared between two groups. The differences of different degrees of stenosis were analyzed in two groups. The differences of different locations of stenosis in patients with vertebral basilar artery stenosis were analyzed in two groups. Logistic regres?sion analysis was used to analyse the factors affecting MES. Results There were no significant differences in age, gender, history of hypertension and diabetes mellitus between the two groups (P<0.05). There were significant differences in the dif?ferent degrees of stenosis between two groups, no or mild stenosis was found in MES-negative group and severe stenosis in MES-positive group (P<0.05). There were 70 cases with no vertebral basilar artery stenosis, 86 cases with mild, moderate and severe stenosis, in which 14 cases were MES-positive and 72 cases were negative. There were significant differences in different locations of stenosis between the two groups. The proportion of multiple infarctions was significantly higher in MES-positive group than that of MES-negative group (P<0.05). The intracranial vertebral basilar artery stenosis and 75%of ver?tebral basilar artery stenosis were the independent risk factors of MES-positive. Conclusion Severe stenosis of the verte?bral basilar artery is more vulnerable to occur MES of posterior circulation, leading to cerebral infarction. Microemboli may be the cause of multiple infarctions in patients with vertebral basilar artery stenosis.