The Effect Of DL-3-n-butylphthalide In Patients Of Acute Multiple Lacunar Infarction With Mild Cognitive Impair

Objective: DL-3-n-butylphthalide(NBP)is recommended to use in the acute stroke by theChinese cerebravascular disease therapy guidelines (2010).Mild cognitive impair(MCI) is thestate between the aging and the dementia. multiple lacunar infarction(MLI) usually exists withMCI but often is ignored in clinic. Montreal Cognitive Assessment(MoCA) is acceptedcomprehensively as a tool to screen MCI. Superoxidase dismutase(SOD)is oxygen-derived freeradicals and can protect our neural system while acute stroke happens.The study here aims to useoral NBP to treat patients of acute MLI with MCI for 8 weeks to investigate the impact of NBPon the changes of the assessment scores of MoCA and serum SOD level and explore themechanism of the change ,to discuss the importance and meaning of NBP using in early subtalcognitive impair patients to protect them from dementia.Methods: According to strict joining group standard, 40 patients of acute MLI with MCI areaccepted in this study.After informed the test aim ,giving permission,the patients were allocatedrandomly to two groups,one is NBP treatment group(n=20) ,the other is controlling group usingpiracetam tablets (n=20).after 8 weeks,they were required to take the MoCA again then got thenew scores .All the patients were extracted venous blood (4ml each person in the morning andfasting required)that the serum was separated from as samples.the samples were kept for lowtemperature (20degrees below zero)then sent for SOD evaluation. ELISA method is used.Results:1. MoCA Scores:1.1. The before and after self control study in treatment group:the change has the statisticallymeaning(P<0.05)1.2. The before and after self control study in controlling group:the change has the statisticallymeaning(P<0.05),suggest high possibility of the level of cognitive impair decreasing whileusing piracetam.1.3. The change between the two groups are tested to be satistically meaningful,that suggestNBP can improve the level of cognitive impair in patients of MLI with MCI besides thefactors such as the natual progress of disease the age and sex ,et.2. Serum SOD Level:2.1 The change between the before and after treatment in NBP group is tested to be statisticallymeaningful (P<0.05) 2.2 The change between the before and after treatment incontrolling group has no meaning instatistics after being tested(P>0.05).2.3 The after treatment level between the two groups is tested to be statistically meaningful.(P<0.05)Conclusions:1. NBP can ameliorate the CI in patients of acute MLI with MCI2. NBP can improve the level of SOD in these patients,showing its abilityto protect neuralsystem from ischemia injury.3. Some individuals can reach the normal score after treatment with NBP,suggeat that NBP canbe used to early subtal CI to avoid dementia in such patients,and provide the rigid evidenceof using NBP as a method to response to early subtal CI patients from dementia.4. AS is seen that both of the change of MoCA scores and SOD level in NBP group arestatistically meaningful,we conclude that the mechanism of NBP on CI is probablyassociated with serum SOD level .5. AS is seen that the change of MoCA scores in piracetam group is statistically meaningfulwhile the serum SOD is not ,we conclude that SOD level is not the single affecting factor tothe CI level,that is ,to improve the SOD level in patients is not the unique mechanism ofNBP ameliorating the CI level .