| Objective: Observing the effect of butylphthalide combined with Atorvastatin on acute ischemic stroke with middle cerebral artery stenosis(Acute Ischemic stroke,AIS),to explore the clinical value of butylphthalide combined with Atorvastatin in improving cerebral perfusion,and to seek new evidence for long-term treatment of ischemic stroke.Methods: 26 patients with ischemic stroke confirmed by MRA in the second affiliated Hospital of The Second Hospital of Dalian Medical University from January 2016 to January 2020 were divided into butylphthalide combined with Atorvastatin group(n = 16)and Atorvastatin group(n = 10).According to the guidelines for early management of acute ischemic stroke,all patients were treated with aspirin(100mg)+ clopidogrel(75mg)against platelet aggregation and ginkgo biloba extract.The statin group was given an intensive dose(40mg)at night and changed to a standard dose of 20 mg after 14 days for 6 months.The butylphthalide group was treated with butylphthalide injection 100 ml twice a day by intravenous drip,and after 7 days,the butylphthalide soft capsule 0.2 g was taken orally three times a day for 3 months.Magnetic Resonance Angiography,MRA examination and evaluation of cerebral vessels,ASL sequence monitoring of Cerebral Blood Flow,CBF and the National Institute of Health Stroke Scale,NIHSS score,Modified Rankin Scale,mRS score,Activity of Daily Living,ADL evaluations were performed within 1 week in hospital and 6 months after discharge in both groups.SPSS 23.0 statistical software was used for data analysis and processing,P<0.05 indicates that the sample difference is statistically significant.Results: 1.There was no significant difference in baseline data between butylphthalide group and statin group,sex,age,previous history(smoking history,hypertension,diabetes,coronary heart disease,hyperlipidemia),baseline score(NIHSS,mRS,ADL)and degree of vascular stenosis(P>0.05).2.The scores of NIHSS,mRS and ADL in butylphthalide group after treatment were significantly lower than those before treatment(0.13±0.34/1.88±1.75)?(0.13±0.34/1.38±1.03)?(20.25±0.68/25.69±2.33),the difference is statistically significant(P<0.05).The scores of NIHSS,mRS and ADL in statin group after treatment were significantly lower than those before treatment(0.4±0.52/1.2±1.03)?(0.4±0.52/1.00±0)?(20.4±0.84/24.0±2.91),the difference is statistically significant(P<0.05).The scores of NIHSS,mRS and ADL in the butylphthalide group after treatment were significantly lower than those in the statin group,and the reduction rates were(85.71±36.31%/66.67±25.82%)?(87.5±34.16%/60±51.64%)and(20.52±8.06%/14.03±9.33%).However,there was no significant difference between the two groups(P>0.05).3.The CBF value of butylphthalide group after treatment was higher than that before treatment(51.58 ±11.26/42.65±12.97),the difference is statistically significant(P<0.05),while CBF value of statin group was slightly lower than that before treatment(29.99±16.05/36.41 ±14.69),the difference was statistically significant(P<0.05);After treatment,the improvement of cerebral perfusion in the butylphthalide group was significantly better than that in the statin group,and the improvement rate of CBF was(32.05±40.80%/-18.68±28.50%),and there was significant difference between the two groups(P<0.05).Conclusion: 1.Long-term use of butylphthalide and Atorvastatin can promote the recovery of neurological function.Butylphthalide sequential combination of Atorvastatin is more effective and can be used as a long-term treatment option for patients with ischemic stroke with middle cerebral artery stenosis.2.Increasing cerebral blood perfusion is one of the mechanisms of butylphthalide promoting the recovery of neurological function. |
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