The Treatment Effects Of Probucol On The Middle Cerebral Artery Stenosis

Objective: In our country ,there will be two million stroke patients to happen each year, one of 70% for ischemic stroke and ischemic stroke by 30%-70% with intracranial arterial stenosis related. The treatment of intracranial and extracranial artery stenosis is drug and non-drug treatment. Non-drug therapy must be based on drug treatment, mainly surgery and endovascular stent. The most mature and the most study is extracranial carotid artery stent angioplasty, and intracranial arterial stenosis angioplasty and thrombolysis in acute arterial surgery have evidence of a lack of evidence—based medicine. However, higher cost of stenting, combined with some patients with intracranial artery stenosis is not suitable for stenting line, so if medical treatment can achieve a certain effect, not only to middle cerebral artery stenosis to prevent further increase, but also aids restenosis after drug treatment, to prevent the occurrence of restenosis. The clinical observation of this study was to study taking tablets Probucol after the long-term (6 months) whether patients with middle cerebral artery (middle cerebral artery, MCA) stenosis have a reverse effect.Methods: MCA in intracranial aneurysms are the most representative wide—ranging, the most commonly affected. And compared to posterior circulation vessels, its variation is relatively small, running path and transcranial Doppler(TCD)through the temporal window suitable for the detection point of view, so its clinical research data is the most abundant. MCA were selected as a research vessel. We use the United States Nicolet produced cerebrovascular TC-8080 Doppler (TCD) instrument on the June 2007 -2008 years in November for treatment in my hospital symptomatic middle cerebral artery stenosis for follow-up of 37 cases were randomly divided into treatment group and control group, in the treatment group of 20 and in the control group of 17 people, including 26 cases of male and 11 females, aged 39-74 years old, average 56.03 years old. Probucol treatment group using films, the first month on 0.50g, daily oral 2, the 2-3 months of oral 0.25g day 2, the 4-6 months 0.125g, daily oral 2; combination of aspirin enteric-coated tablets 100mg, oral daily 1. Application of the control group of aspirin enteric-coated tablets 100mg, oral daily 1. Generally take 6 months. In addition, if the patients have high blood pressure, diabetes, smoking, drinking, with control of high blood pressure, high blood sugar, smoking cessation, alcohol and other treatment. Drug use before and 6 months later, color Doppler ultrasound examination of brain(the 2 inspections are to operate the same equipment, apparatus, consistent set of parameters, recording the parameters)was used to detect the peak flow velocity, mean velocity and spectrum Morphological changes in access to clinical data to determine the basis of ultrasound diagnosis of vascular stenosis narrow standards and effective reversal of the standard clinical data collected using SPSS statistical analysis software.Results: After 6 months of clinical observation, treatment group each 3 months with a review of 5 cases and the 6 months with a review of 15 cases. Control group each 3 months with a review of 2 cases and the 6 months with a review of 15 cases. Finally, the results of the first 6 months to review are as data. Treatment group and control group in age, sex, smoking history, alcohol history, diabetes history, history of heart disease, history of hypertension and other risk factors showed no significant difference between(P> 0.05). Both in peak flow velocity as a standard or mean as the standard, prior to the application of the drug,the treatment group and the control group the number of people in a narrow distribution of the degree of no significant difference P> 0.05. After 6 months , the same indicator are re-reviewed to peak velocity for the stenosis standards , the grading of the extent of the distribution of the number of significant differences P <0.05, while the mean flow velocity for the standard there was no significant difference P> 0.05. After 6 months in the treatment group there were 10 overall improvement in the trend of the degree of stenosis and in the control group 7 aggravation, the majority of non-hierarchical change its velocity to speed up more. Vm ,as standards, there was no significant difference P> 0.05, although the treatment group compared with the control group both the P> 0.05 before and after taking drugs, but the treatment group P value itself had changes in taking drugs before and after, the trend of reducing the overall average blood flow velocity has a downward trend. Comprehensive analysis of Vp, Vm, as well as the spectrum shape, the progress in the treatment group 1 pepole, and the stability of 2 people, 18 people turn for the better; as well as progress in the control group of 9 people, the stability of 7 people, 4 people a turn for the better. In addition, the vesting of the two groups to carry out a comparative analysis of the situation, in accordance with the vesting of the good and bad values are divided into varying degrees, from the peak flow velocity, the mean spectrum, respectively, compared patterns, the treatment group, respectively, of the vesting of the projects are good in the control group, P <0.05. Combined with a comprehensive evaluation of the overall prognosis of the treatment group than the control group. 6 months in the follow-up, combined with Probucol and aspirin on the middle cerebral artery stenosis have a certain effect. In spite of this, this study there is no large sample randomized controlled studies, its effectiveness, safety and long-term prognosis has yet to be explored further. If the large sample randomized controlled study has confirmed, it still prove Probucol combination aspirin on the middle cerebral artery stenosis have a certain effect, it will be a lot of patients with MCA Gospel.Conclusion:1. TCD as a safe and effective inspection tool can be used for evaluation of follow—up examination of patients with MCA stenosis vesting and prognosis.2. Probucol United aspirin can reduce the extent of MCA narrow, reducing blood flow velocity and average peak flow velocity and shape of the spectrum with a turn for the better.3. Clinical application of Probucol in a longer time(generally six months or more), long—term effect could be better.4. Because of small sample size in this study belong to clinical observations, Probucol safety, efficacy and long—term prognosis still need to be further large sample randomized controlled study.