The Effect Of Lipo-PGE₁on Cerebral Blood Flow In The Ischemic Area Of Acute Cerebral Infarction

Objective:To observe the effect of Lipo-PGE1(Liposomal Prostaglandin E1) on the improvement of neurological deficit and the selective improvement of the rCBF (regional cerebral blood flow) in patients by SPECT(Single-Photon Emission Computed Tomography), whether it will cause the ISP (intracerebral steal phenomenon)Methods:Sixty acute cerebral infarction patients were randomly divided into treatment group(n=30) and control group(n=30). The basic therapy for control group is aspirin and edaravone, and symptomatic and supportive treatment for14days. Medication based on the control group, the treatment group use lipo-prostaglandin E1(Lipo-PGE1)10μg/d, adding100mL normal saline intravenously for14days. Neurological deficit scores of patients in two groups were measured before and after treatment. To observe the changes of regional cerebral blood flow tomography images of two group before and after treatment by SPECT, to delimit ROIs(region of interest) and to measure the average radioactive count of the focal ROIs and the uninjured side mirror image ROIs, and to measure the average radioactive count of the healthy referential ROIs and the contralateral healthy referential ROIs, and then investigate the change of rCBF.Results:1. Neurological deficit scores of the treatment group and the control group:Compared with the neurological deficit scores before and after the treatment of the treatment group, the scores was reduced and the difference was statistically significant (P<0.05). Compared with the neurological deficit scores before and after the treatment of the control group, the scores was reduced and the difference was statistically significant (P<0.05). Compared with the neurological deficit scores between the treatment group and the control group after treatment, the scores was lower in treatment group than the control group, the difference was statistically significant (P<0.05)2. The average radioactive count in the ROIs of the treatment group and control group:The average radioactivity count in the focal ROIs of the treatment group increased significantly, and the difference before and after the treatment was statistically significant (P<0.05). The average radioactivity count increased in the uninjured side mirror ROIs of the treatment group, the difference before and after the treatment was statistically significant (P<0.05). The average radioactivity count increased in the focal ROIs of the control group, the difference before and after the treatment was statistically significant (P<0.05). The average radioactivity count increased in the uninjured side mirror ROIs of the control group, the difference before and after the treatment was statistically significant (P<0.05). The average radioactivity count was similar in the focal ROIs between the treatment group and the control group before treatment, the difference was not statistically significant (P>0.05), but the difference after treatment was statistically significant (P <0.05). The D-value of average radioactivity count was large in the focal ROIs between the treatment group and the control group, the difference was statistically significant (P<0.05). The average radioactivity count was similar in the uninjured side mirror ROIs between the treatment group and the control group before treatment, the difference was not statistically significant (P>0.05), and the difference after treatment was not statistically significant (P>0.05). The D-value of average radioactivity count was small in the uninjured side mirror ROIs between the treatment group and the control group, the difference after treatment was not statistically significant (P>0.05)3. The average radioactivity count in the focal ROIs, the uninjured side mirror ROIs, the normal referential and the contralateral mirror ROIs of the treatment group:The average radioactivity count were increased before and after treatment, the difference was statistically significant (P <0.05)Conclusion:1. Lipo-PGE1can effectively improve the neurological deficit in patients with acute cerebral infarction.2. To observe the change of rCBF after the treatment of Lipo-PGE1by using regional cerebral blood flow tomography of SPECT, the rCBF of the focus has significantly improved, and the average radioactivity counts of the focal ROIs has obviously increased. The results indicate that Lipo-PGE1can selectivity treat the diseased blood vessel of focus.3. By using regional cerebral blood flow tomography of SPECT, we found that Lipo-PGE1in the treatment for acute cerebral infarction patients didn’t cause the intracerebral steal phenomenon.