The clinical efficacy and safety evaluation of butyphthalide-combined thrombolytic therapy on acute cerebral infarction in the elderly / 中华老年医学杂志

ABSTRACT

Objective:To evaluate the clinical effect and safety of the thrombolysis-combined butyphthalide therapy on acute cerebral infarction.Methods:A total of 58 patients with acute cerebral infarction receiving thrombolytic therapy in Henan Provincial People's Hospital from June 2016 to August 2018 were randomly divided into the thrombolytic group(recombinant tissue type plasminogen activator i. e.rt-PA, n=29)and the group of butyphthalide plus rt-PA(n=29). Neurological function(National Institutes of Health Stroke Scale, NIHSS), daily living ability(Barthel index score)and the ultrasound-detected cerebral blood flow were compared between the two groups to evaluate the clinical efficacy and safety.Results:After the treatment, NIHSS score was significantly lower in the group of butyphthalide plus rt-PA than in the thrombolysis group(5.24±2.61 vs.8.15±2.55 points, P=0.015). The Barthel index was significantly higher in the group of butyphthalide plus rt-PA than in the thrombolysis group(75.32±4.42 vs.57.37±3.54 points, P=0.024). The cerebral blood supply was improved in both groups after treatment as compared with pre-treatment.After treatment, the peak flow velocity of middle cerebral artery was 78.34±4.82 cm/s and 67.16±3.37 cm/s( P=0.017)and the average flow velocity of the middle cerebral artery was(44.19±2.18)cm/s and(37.49±2.16)cm/s( P=0.029)in the group of butylphthalide plus rt-PA than in the thrombolysis group, respectively, which showed the blood supply of the middle cerebral artery was better in butyphthalide plus rt-PA therapy than in thrombolytic therapy.Clinical effective rate was 89.7%(26/29)in butyphthalide plus rt-PA group, which was better than that in the thrombolysis group(65.5%, 19/29)( χ2=4.851, P=0.029). During the treatment, 2 patients had mild gastrointestinal reactions in both groups, which were relieved after treatment of symptoms, and no serious adverse reaction occurred in other patients. Conclusions:The combined therapy of butyphthalide and thrombolysis can improve clinical efficacy rate on acute cerebral infarction, improve the cerebral hemodynamics, promote the recovery of neurological function, and improve the quality of life of patients.