Clinical Study On Butylphthalide Treating Ischemic Stroke By Mobilization Of Endothelial Progenitor Cells

Object To explore the correlation between the number of endothelial progenitor cells andthe National Institute of Health stroke scale (NIHSS) on acute ischemic stroke patients, andthe relationship between the change of endothelial progenitor cells and that of NIHSSscore after NBP treatment. The long-term effect of NBP was also analyzed.Methods196cases with fiirst acute ischemic stroke within48hours of onset were enrolledin the department of Neurology, the first affiliated hospital of Soochow University fromSep1st,2010to Sep1st,2011.96cases were screened out according to the inclusion criteriaand randomized into two groups, ie NBP treatment group and placebo group according torandom digital table. Take30days as a course of NBP treatment. EPCs were marked asCD34/CDl33/KDR three labeled cells by flow cytometry detection. EPCs levels weredetected at baseline,7days,14days and30days after therapy in96screened cases.NIHSS scores were also detected at baseline,7days,14days,30days and90days aftertherapy. Only the number of EPCs and NIHSS score at baseline were detected in the100unselected patients.Results1Multiple linear regression analysis showed correlations between the number of EPCs andold age, hypertension, diabetes, atherosclerotic plaque formation and TIA.2It was negative correlation between NIHSS score and the number of EPCs at baseline inacute ischemic stroke patients (r=-0.593, P=0.000).3Repeated measures ANOVA showed that there were significant differences (P <0.05) inthe number of EPCs and NIHSS scores in the patients between NBP group and placebogroup（P<0.05）. 4The number of EPCs of NBP treatment group was significantly increased at7days,14days and30days after therapy when compared with those of baseline. The number ofEPCs was markedly increased at7days and14days after NBP treatment when comparedwith that of placebo group in the same period （P<0.05）. NIHSS score was notsignificantly changed after7days NBP treatment, and there was no significant differencewhen compared with placebo group at same period (P>0.05). NIHSS score wassignificantly lower than that of baseline at14days,30days and90days after NBP treatment,and also markedly lower than placebo group at same period（P<0.05）.5At follow-up peroid (within three months after onset) ischemic events in NBP groupwere slightly lower than those of placebo group, but there was no significant differencebetween two groups (P>0.05). There were no serious adverse events in the two groups.Conclusions1All of those stroke risk factors will reduce the level of circulating EPCs in patients withacute ischemic stroke, such as old age, hypertension, diabetes, atherosclerosis,atherosclerotic plaque formation and TIA. The severity of acute ischemic stroke wascorrelated with the levels of EPCs at baseline.2NBP treatment could improve neurologic impairment score and prognosis bymobilization of circulating EPCs. It’s safe and effective.