The Clinical Study Of The Treatment For Acute Cerebral Infarction Super Early Stage With Dl-3n-Butylphthalide And Sodium Injection

Objectives To observe clinical effect in patients with acute anterior circulation cerebral infarction with dl-3n-Butylphthalide in different time windows; To investigate the mechanism of the dl-3n-Butylphthalide by CTPI, and provide a new basis for the best timing for application of dl-3n-butylphthalide in such patients.Methods The 168 patients of acute cerebral infarction were divided into two groups randomly, the treatment group(88 cases) and control group(80 cases); The control group was given 0.9% Sodium Chloride Injection 100 ml static 2/ day, and given the inhibition of platelet aggregation, neural protection, Invigorate the circulation of blood, antihypertensive, anti-diabetic, and other conventional treatment,the time interval of 8 hours, and for 14 days; The treatment group was treated with dl-3n-Butylphthalide on the basis of conventional therapy(NBP; Pharmaceutical Group butylphthalide Pharmaceutical Co Ltd) 100 ml PE infusion, 2/day, the time interval of 8 hours, and for 14 days. Record NIHSS score, BI index score at admission,use seventh days, fourteenth days and 30 days respectively and observe the recovery of neurological functions. And then the treatment group were divided into two groups according to the admission time, A group(30 cases) within 8 hours, including Thrombolysis contraindication or do not agree with thrombolytic therapy in patients with ACI;B group(58 cases) within 8 to 48 hours, recorded NIHSS and BI index scores after seventh days, fourteenth days and thirty days after treatment. Select 19 cases of patients with complete CT plain scan, CTA and CTPI, and the ACI patients of onset time is within 8 hours. The control group of 9 cases and 10 cases in the treatment group, to record the admission and 14 days after treatment in patients with the complete CTA-CTPI examination, recording the ischemic zone of CBF, CBV, TTP, MTT value were processed by CT Perfusion software, The comparison of the two groups in the CBF region CBV, TTP, MTT, they have Significant difference before and after treatment, and have further evaluation of the collateral circulation.Results The the experience group and the control group of NIHSS score and BI index score and ability of daily life before treatment baseline have no significant difference(P>0.05); There was statistical significance of NIHSS scores and BI index scores between the two groups before and after treatment(P<0.05), and the experience group have more significant. The treatment group of NIHSS score and BI index were statistically significantdifference(P<0.05) after treatment of seventh days, fourteenth days and 30 days compared with the control group; Comparing the treatment group of NIHSS scores and BI scores at different time of 7 days, 14 days, 30 days after the treatment, and the self-care ability was statistically significant(P<0.05); The NIHSS and BI index changes significantly within 8 hours of symptom onset,the recovery of neurological function effect is remarkable. Study of 19 cases by CT scan, CTA and CTPI examination, the cerebral hypoperfusion area had no significant difference before treatment(P>0.05). The two groups of infarction center and ischemic penumbra with CBF, CBV, MTT,TTP have significant difference before and after treatment(P<0.05), and the treatment group showed more significant differences. That is said the early application of butylphthalide and sodium chloride injection can increase cerebral blood flow,improve the cerebral perfusion, and promote the establishment of collateral circulation possibly.Conclusions 1 dl-3n-Butylphthalide can improve the symptoms of acute neurologic impairment in patients with cerebral infarction significantly and improve patients of selfcare ability,and have good prognosis; 2 The incidence of dl-3n-Butylphthalide were used earlier, the better clinical neurological function patients recovery; 3 It can increase cerebral blood flow of cerebral ischemia areas with dl-3n-butylphthalide applied Earlier,and it may be related to the establishment of collateral circulation. Observe the cerebral blood flow perfusion of acute cerebral ischemic area by CTPI, provide clinical guidance for the early diagnosis and treatment.