The Effect Analysis Of Improving The Prognosis Of Intravenous Thrombolysis In Acute Cerebral Infarction With Butylphthalide And Sodium Injection

Objective: Using the mechanism of anti-ischemia and improve the collateral circulation,to explore the prognosis effect of patients with ultraearly cerebral infarction who gave Butylphthalide and Sodium Chloride Injection before intravenous thrombolysis.Using head MRA,ASL to analyze recanalization of blood vessel and collateral circulation,and verify the effect of Butylphthalide and Sodium Chloride Injection on vascular recanalization and collateral circulation.Methods: 81 cases were randomly divided into 2 groups.The first group was the control group of 40 cases and the second group was the experimental group of 41 cases.The control group was directly treated with rt-PA intravenous thrombolytic therapy according to the guidelines of thrombolytic therapy.The experimental group which decided to be treated with thrombolysis after head CT examination,immediately gave intravenous Butylphthalide and Sodium Chloride Injection(NBP injection,CSPC NBP Pharmaceutical Co.Ltd)100ml by PE Infusion device in the process of waiting for test or transfer.After the condition was stabilized or reviewing head CT without intracranial hemorrhage,sequentially gave 2/ day intravenous Butylphthalide and Sodium Chloride Injection100 ml by PE Infusion device,two intervals for 7 hours,used for 14 days.Both of two groups were given routine treatment such as neuroprotection,activating blood circulation to dissipate blood stasis,lowering blood pressure and blood sugar,falling fat and stabling plaque.Reviewing the head CT at any time when patient's condition was changed.If patient's condition was not changed,head CT was performed 24 hours after thrombolysis,and without intracranial hemorrhage,the patient was treated by inhibition of platelet aggregation.NIHSS scores,BI index scores and observing the recovery of nerve function were recorded separately at the time of 1 hour,7 days and 14 days after the treatment.Hemorrhagic transformation and death of two groups after thrombolysis were recorded.Head MRA+DWI+ASL were performed within 24 hours after intravenous thrombolysis,the images of ASL examination were recorded and processed by software functool 5×2.1.08,and CBF values of the interest region were recorded,compared the difference of lesion area CBF and vascular recanalization between the two groups.According to the situation of vascular recanalization after thrombolysis,patients with or without vascular recanalization,NIHSS scores,BI index scores,observing the recovery of nerve function and CBF values were compared separately at the time of being hospitalized,1 hour,7 days and 14 days after the treatment.Results:1 Before treatment,the difference of baseline level,NIHSS scores and BI index scores in the two groups was not statistically significant(P>0.05),which can be compared;2Before and after treatment,the difference of NIHSS scores and BI index scores in the two groups was statistically significant(P<0.05),experimental group was more significant.The comparison of NIHSS scores and BI index scores at hour 1,day 7 and day 14 after treatment between the two groups was statistically significant(P<0.05);3Head MRA examination was performed after intravenous thrombolysis,the comparison of recanalization rate between the two groups was statistically significant(P<0.05);4Head DWI+ASL examination was performed after intravenous thrombolysis,the comparison of CBF between the two groups with anterior circulation cerebral infarction was statistically significant(P<0.05).55 cases of patients without vascular recanalization,the comparison of CBF between the two groups was statistically significant(P<0.05);5The comparison of hemorrhagic transformation,deterioration and death ratio after intravenous thrombolysis between the two groups was statistically significant(P<0.05).Conclusion:1 Giving intravenous Butylphthalide and Sodium Chloride Injection before intravenous thrombolysis in ultra-early cerebral infarction,could improve the effect of intravenous thrombolysis and recanalization rate.2 Giving intravenous Butylphthalide and Sodium Chloride Injection before and after intravenous thrombolysis in ultra-early cerebral infarction,patients without vascular recanalization could still get satisfactory results.3 The mechanism of Butylphthalide and Sodium Chloride Injection to improve rt-PA thrombolytic therapy efficacy could be related to the improvement of collateral circulation.