Clinical Study On Vinpocetine Treatment For White Matter Ischemic Lesions

[Objective]To observe the effectiveness and safety of vinpocetine on white matter ischemic lesions.[Methods]62 cases of patients admitted to our hospital and clinically diagnosed as ischemic cerebrovascular disease from January 2013 to October 2014 were selected. These patients were diagnosed as white matter ischemic lesions.(Fzakas level 3) according to cranial MRI and divided into vinpocetine medicine group(33 cases) and control group(29 cases) using randomized controlled and autologous parallel controlled research methods. The medicine group received intravenous injection of 30 mg of Vinpocetineinjection(Cavinton, batch number: A33116A) for 14 days and kept taking vinpocetine pills(Cavinton, batch number: T1B190B) 10 mg orally, tid for the rest of three months. During the trial, aspirin enteric-coated tablets 100 mg, qd and atorvastatin calcium tablets 20 mg, qd were constantly used in both groups. Other kinds of medicine like recognition-improving medicine, vasodilator and leptuntic were forbidden during the trial.All patients had been assessed by Montreal Cognitive Assessment(Mo CA) and the bias of their education background had been regulated according to the assessment score(add 1 point to the base score of the patients with a 12-year or shorter education background). NAA/Cr and Cho/Cr in 1HMRS, PI value in cranial TCD, ADL index were also assessed. In the fourteenth day of the treatment, Mo CA, ADL index, cranial TCD and MRS examination were measured and recorded by the same scorer. In the third month, Mo CA and ADL index assessments were carried out. The clinical effect and adverse effect of vinpocetine were observed through the changes of related index in medicine group before and after treatment, as well as the comparison of recognition, ADL, imageology and vascular function between the two groups.[Results]1. There is no significant statistical difference between general situation, age, and gender and education background of the patients selected in two groups(P>0.05), with comparability.2. On the fourteenth day of treatment, the Mo CA score and ADL index in the medicine group increased significantly while NAA/Cr somewhat increased and PI value decreased evidently compared to pretreatment level. All these had significant statistical difference(P<0.05). However, Cho/Cr had no significant statistical difference compared to pretreatment level(P>0.05). After 3 months’ treatment, Mo CA score and ADL index increased significantly compared to the level at fourteenth day after treatment and pretreatment level and had significant statistical difference(P<0.05).3. On the fourteenth day, the Mo CA score, ADL index, PI value, NAA/Cr and Cho/Cr in control group didn’t show any significant statistical difference(P>0.05) compared to pretreatment level. In the third month, Mo CA score and ADL index had no significant statistical difference(P>0.05) compared to both pretreatment level and the fourteenth day’s level.4. Mo CA score, ADL index, PI value, NAA/Cr and Cho/Cr didn’t show any significant difference(P>0.05) between two groups before treatment. After 14 days’ treatment, PI value decreased significantly and NAA/Cr increased evidently in medicine group compared to control group and these had significant statistical difference(P<0.05). However, Mo CA score, ADL index and Cho/Cr value in two groups had no significant statistical difference(P>0.05). After 3 months, Mo CA score and ADL index in medicine group showed an obvious increase compared to control group and they had significant statistical difference(P<0.05).5. Safety analysis: Patients in control group and medicine group were all normal in examination before treatment, including routine blood and urine test, coagulation, liver and kidney function, blood glucose and electrocardiogram. 5 of 62 patients had adverse reaction during observation. Among them, 2 cases in control group showed an increased transaminase level and it seemed to be associated with the usage of statin since they ameliorate after drug withdrawal. Among the other three cases in vinpocetine group, 1 case showed upper airway infection symptoms and recovered after symptomatic treatment, 1 case showed an increase transaminase level and recovered after follow-up, 1 case had postural hypotension that seemed to be associated with vinpocetine usage and recovered after follow-up. The trial was successfully accomplished. The total adverse reaction rate among two groups had no significant statistical difference(P>0.05), indicating that patients with white matter ischemic lesions using vinpocetine chronically didn’t show evident adverse reaction.[Conclusions]Vinpocetine is effective and safe in the treatment of white matter ischemic lesions. It is a new kind of medicine that is effective and beneficial to patients chronically.