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2.
Front Neurol ; 12: 720664, 2021.
Article in English | MEDLINE | ID: mdl-34630292

ABSTRACT

Background: Dl-3-n-Butylphthalide (NBP) has the potential to improve clinical outcomes in acute ischemic stroke patients by improving collateral circulation. We aimed to evaluate the efficacy and safety of NBP in patients with non-disabling minor ischemic stroke and transient ischemic attack (TIA). Methods: The BRIDGE (the observation study on clinical effectiveness of NBP on patients with non-disabling ischemic cerebrovascular disease) is a prospective registry to monitor the efficacy and safety of NBP therapy in acute non-disabling ischemic stroke or high-risk TIA. Non-disabling minor ischemic stroke patients within 48 h were enrolled across 51 stroke centers in China. We divided patients into NBP compliance or non-compliance groups according to their adherence to NBP. The primary outcome was the favorable functional outcome at 90 days, defined as a modified Rankin scale (mRS) <2. Results: Between 10th October 2016 and 25th June 2019, 3,118 patients were included in this analysis. In multivariable analysis, Between 10th October 2016 and 25th June 2019, 3,118 patients were included in this analysis. In multivariable analysis, after adjusting for common risk factors and demographic factors, NBP-compliance group has a higher proportion of favorable functional outcome (92.1 vs. 87.4%, adjusted odds ratio 2.00, 95% confidence interval, 1.50­2.65), and a higher stroke recurrence rate (2.40 vs. 0.31%, adjusted odds ratio 8.86, 95% confidence interval, 3.37­23.30) than the NBP-non-compliance group. There was no significant difference in death and intracranial hemorrhage rate between the two groups. In subgroup analysis, patients with National Institutes of Health Stroke Scale (NIHSS) scores from 3 to 5 who complied to NBP therapy had a higher rate of favorable functional outcomes than the NBP-non-compliance group. [88.82 vs. 76.21%, adjusted odds ratio 2.52 (1.81­3.50), adjusted interaction P = 0.00]. Conclusion: In non-disabling minor ischemic stroke or TIA patients, compliance with NBP therapy led to better 90-day functional outcomes despite a higher risk of recurrence, and this effect seems to be stronger in patients with NIHSS scores of 3-5. Further large randomized, double-blind controlled studies to analyse the association between NBP and functional outcome is warranted in the coming future.

3.
Zhonghua Yi Xue Za Zhi ; 90(11): 748-51, 2010 Mar 23.
Article in Chinese | MEDLINE | ID: mdl-20627019

ABSTRACT

OBJECTIVE: To investigate the relationship between abdominal obesity and intracranial artery stenosis and the underlying mechanism. METHODS: By cluster sampling, 1405 adult Han people were selected from the residential communities. Among them, 1035 people conformed to the inclusion criteria. Medical history was documented and body height, body weight, waist circumference, hip circumference and blood pressure were measured. Venous blood samples were collected to detect the serum concentrations of fasting glucose, total cholesterol and triglycerides. Serum nitric oxide (NO) level was determined by cadmium reduction method. Middle cerebral artery stenosis (MCAS) was diagnosed by transcranial Doppler. The SPSS 11.0 software package was used for data analysis. RESULTS: MCA stenosis was found in 66 subjects (6.4%). Univariate analysis showed history of hypertension, history of ischemic heart disease, systolic blood pressure and diastolic blood pressure were the risk factors for MCAS and waist-to-hip ratio (WHR) was a risk factor only in males. Logistic regression demonstrated history of hypertension was an independent risk factor for MCAS both in males and females (P = 0.011, P = 0.009) and WHR for MCAS only in males (P = 0.030). Among males and females over 55 years old, the NO levels were higher in people with a higher WHR and the difference was statistically significant (P = 0.042, P = 0.016); however the NO levels for people with a varying WHR showed statistically insignificant difference among females under 55 years old (P = 0.228). CONCLUSION: Hypertension and abdominal obesity are important risk factors for MCAS. Endothelial cell dysfunction and an elevated level of oxidative stress may be involved in the atherogenetic mechanism of abdominal obesity while estrogen may play a protective role in it.


Subject(s)
Hypertension/epidemiology , Intracranial Arterial Diseases/epidemiology , Obesity, Abdominal/epidemiology , Adult , Aged , Aged, 80 and over , Constriction, Pathologic , Female , Humans , Hypertension/complications , Intracranial Arterial Diseases/complications , Male , Middle Aged , Obesity, Abdominal/complications , Risk Factors , Surveys and Questionnaires
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