Effect Of Edaravone And Butylphthalide On Nervous Function And Serum Inflammatory Factors And Free Radicals In Patients With Acute Cerebral Infarction

Objective1.To investigate the effect of butylphthalide and edaravone on the serum free radicals balance system in patients with acute cerebral infarction,to compare the curative effect,and to provide the basis for clinical medication.2.To investigate the effect of butylphthalide and edaravone on the serum Inflamematory factors in patients with acute cerebral infarction,and on the improvement of nerve function defect,in order to provide theoretical basis for clinical medication.MethodsA total of 150 patients of acute cerebral infarction who were confirmed by craniocerebral CT or MR,and selected on January 1,2014 to June 30,2015,at the onset of Neurology ward two of our hospital in 6 hours to 72 hours,were randomly divided into three groups:(1)The conventional treatment group(regular group for short): 50 cases,32 cases of male,female 18 cases,with an average age of 63.30±8.25.was conventionally to be given Aspirin enteric tablets 100 mg,Simvastatin pills 10 mg,Xuesetong powder for injection 400 mg,ozagrel injection 80 mg,and control of blood pressure,blood lipids and blood sugar etc.(2)The edaravone in treatment group(edaravone group for short): 50 cases,28 cases of male,female 22 cases,with an average age of 65.43±10.56.plus edaravone30 mg in 0.9% sodium chloride injection 100 mL on the basis of conventional therapy,for intravenous infusion 30 min,2 times/day.(3)The butylphthalide combined with edaravone in treatment group(butylphthalide group for short): 50 cases,30 cases of male,female 20 cases,with an average age of 64.23±9.26.add butylphthalide injection on the basis ofedaravone group,for intravenous drip 30 min,1 time/day.(4)Control group: choose the same kindergarden 50 cases,26 cases of male and female 24 cases,with an average age of64.60±8.77.The first three groups,respectively,draw off fasting venous blood 4ml for inspection in the day or the next day after admission and 14 days after treatment,and the control draw off fasting venous blood 4ml.These are removed after centrifugal blood serum,and storage-80? waiting for inspection.We need to detect free radical scavenger:GSH(Glutathone),SOD(superoxide dismutase)and lipid oxidation end-products of lipid free radicals malondialdehyde(MDA);and inflammatory factor: TNF – a(tumor necrosis factor-a),NO(Nitric oxide),to observe the changes of inflammatory factors and free radicals in the three groups before and after the treatment.At the same time,observe nerve function defect score(NIHSS)at baseline and after therapy respectively,in order to evaluate clinical efficacy of three groups of patients.Result1.Before treatment,the content of serum GSH,SOD and NO of the Three groups of patients were lower than the control group,and the content of MDA,TNF-a were higher than the control group,the differences were statistically significant(P < 0.05);2 After 14 days' therapy,the content of GSH and SOD in the three groups were higher than before treatments,the content of MDA were decreased,but the content of GSH and SOD in edaravone group and butylphthalide group were higher than in control group,the MDA was lower than control group,the content of GSH and SOD in butylphthalide group were the highest of the three groups,the MDA was the lowest,the differences were statistically significant(P < 0.05);3.After two weeks' therapy,the content of NO in the three groups were higher than before treatment,the content of TNF-a were decreased,but the content of NO in edaravone group and butylphthalide group were higher than in control group,the TNF-a was lower than control group,the content of NO in butylphthalide group was the highest of the three groups,the TNF-a was the lowest,the differences were statistically significant(P < 0.05);The degree of nerve function defect in the three groups was more improved than before treatments,the butylphthalide group was improved the most,and the differences were statistically significant(P < 0.05).3.14 days after,monitoring the liver and kidney function,of the three groups of patients,there were 2 cases,3 cases,3 patients respectively appeared phenomenon of transaminase eleations,which consider for the use of lipid-lowering drugs,as the liver function recovered after stop using lipid-lowering drugs or add liver-protecting medicine.Conclution1.Edaravone can effectively remove the content of free radicals,but butylphthalide combined with edaravone can remove the content of free radicals more effectively,and reduce the oxidative stress injury,in order to protect brain cells better.2.Edaravone can reduce the levels of serum inflammatory cytokines,but butylphthalide combined with edaravone can educe the levels of serum inflammatory cytokines more effectively,and reduce inflammatory damage,promote the nerve functional recovery.The effects is remarkable than using of edaravone singly.It is safe and effective,and is worthy of clinical popularization and application.