| BackgroundCerebral infarction is a kind of cerebrovascular disease,which is characterized by ischemic and anoxic lesions in local brain tissue,followed by neurological deficit.Acute cerebral infarction has a high mortality and disability rate.If the time of treatment is delayed or the treatment is improper,it can seriously affect the daily life of patients.The results show that hypoxia can induce the expression of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)and other growth factors to increase.Under the action of various growth factors,the proliferation and differentiation of cells can take place and angiogenesis can be promoted.Sodium butylphthalide chloride injection is a new type of brain protective agent,its main active ingredient is racemate extracted from celery,which can reduce the intracellular calcium concentration,inhibit the release of free radicals,and prevent the apoptosis of nerve cells.However,at present,there are few studies on the effect of sodium butylphthalide chloride injection on cerebral blood flow perfusion and its mechanism.The purpose of this study is to investigate the effect of sodium butylphthalide chloride injection on angiogenesis related factors,cerebral blood flow perfusion and nerve function in patients with acute cerebral infarction.ObjectiveTo investigate the effects of sodium butylphthalide chloride injection on angiogenesis related factors,cerebral blood flow perfusion and nerve function in patients with acute cerebral infarction.MethodsFrom April 2018 to January 2020,94 patients with acute cerebral infarction who were hospitalized in neurology department of the First Affiliated Hospital of Xinxiang Medical College were selected,and the onset time was within 48 hours,were randomly divided into observation group and control group with 47 cases in each group.Two groups of patients were given routine treatment,the observation group in the routine treatment plus 100 ml of sodium butylphthalide chloride injection intravenous drip,the control group in the routine treatment plus 100 ml of normal saline as a placebo control,all for 14 days.CT perfusion imaging(CTP)was performed before and 180 days after treatment in the two groups,and the National Institutes of Health Stroke Scale(NIHSS)score and activities of daily living(ADL)score was used to evaluate the severity of neurological deficit in the two groups.The concentrations of VEGF and bFGF in serum were determined by enzyme linked immunosorbent assay(ELISA).Spss25.0 software was used for statistical analysis.Results1.Comparison of general information:there was no significant difference between the two groups in gender,age,baseline blood pressure,history of hypertension,history of diabetes,history of hyperhomocysteinemia,history of smoking,history of drinking,fasting blood glucose,blood lipid and other indicators(P>0.05),which was comparable.2.Comparison of perfusion parameters of brain CT:regional blood flow(rCBF),regional blood volume(rCBV),transit time to the peak(TTP),mean transition time(MTT)between the observation group and the control group before treatment,there was no significant difference(rCBF:t=1.547,P=0.125;rCBV:t=0.449,P=0.655;TTP:t=1.920,P=0.059;MTT:t=1.564,P=0.121);after treatment,there were significant differences in rCBF,rCBV,TTP and MTT between the observation group and the control group(rCBF:t=2.091,P=0.039;rCBV:t=2.317,P=0.023;TTP:t=2.269,P=0.026;MTT:t=2.981,P=0.004);there were significant differences in rCBF,TTP and MTT in the control group after treatment compared with that before treatment(rCBF:t=2.511,P=0.016;TTP:t=5.612,P=0.000;MTT:t=4.431,P=0.000),but there was no significant difference in rCBV after treatment compared with that before treatment(t=0.611,P=0.544);after treatment,rCBF and rCBV in the observation group were higher than those before treatment(rCBF:t=19.611,P=0.000;rCBV:t=4.197,P=0.000);while TTP and MTT were lower than those before treatment(TTP:t=16.184,P=0.000;MTT:t=14.549,P=0.000).3.VEGF and bFGF levels:there was no significant difference between the two groups before treatment(VEGF:t=1.700,P=0.093;bFGF:t=0.375,P=0.708);after treatment,the serum VEGF and bFGF in the observation group were higher than those in the control group(VEGF:t=2.416,P=0.018;bFGF:t=2.269,P=0.026);in the control group,there was no significant difference between the levels of VEGF and bFGF after treatment and before treatment(VEGF:t=1.830,P=0.074;bFGF:t=1.953,P=0.057);in the observation group,there was no significant difference in serum VEGF level after treatment compared with that before treatment(t=1.801,P=0.078),while the level of bFGF in serum was significantly different from that before treatment(t=7.188,P=0.000).4.Comparison of NIHSS score and ADL score:there was no significant difference between the two groups before treatment(NIHSS:t=1.080,P=0.283;ADL:t=0.934,P=0.353);after treatment,NIHSS score in the observation group was lower than that in the control group(t=2.038,P=0.044),ADL score was higher than that in the control group(t=3.336,P=0.001);after treatment,NIHSS score in the control group was lower than that before treatment(t=2.029,P=0.048),while ADL score had no significant difference compared with that before treatment(t=1.470,P=0.148);the NIHSS score in the observation group was lower than that before treatment(t=6.301,P=0.000),ADL score was higher than that before treatment(t=9.737,P=0.000).5.Comparison of the clinical efficacy of the two groups:the total effective rate of the observation group was 72.34%,and that of the control group was 57.45%.The total effective rate of the observation group was significantly higher than that of the control group,indicating that the clinical efficacy of the observation group was better than that of the control group,and the difference was statistically significant(χ~2=3.899,P=0.048).ConclusionSodium butylphthalide chloride injection can increase the expression of VEGF and bFGF in the serum of patients with acute cerebral infarction,improve the cerebral perfusion in the ischemic area,promote the recovery of nerve function,and improve the quality of life of patients. |
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