Effect Of Butylphthalide Combined with Ozagrel Sodium on Cerebral Perfusion and Oxidative Stress Indexes in Patients with Transient Ischemic Attack

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Changya Liu, Yun Li, Jianhua Zhou, Chuanxiang Wang, Tao Hu

Abstract

Background The pathogenesis of transient ischemic attack is not clear. Microthrombosis theory is a theory with high clinical recognition. Microthrombosis of carotid artery and vertebral-basilar artery wall occurs shedding and vasospasm, resulting in transient cerebral insufficiency. Microembolic decomposition or distal movement, cerebrovascular dilatation, local collateral circulation after the establishment of symptoms relieved or disappeared.  Most patients can be relieved in a short time, but recurrent attacks can gradually damage the structure and function of brain tissue, and increase the risk of acute cerebral infarction.  The clinical treatment of this disease is mainly based on the comprehensive control of risk factors, anti-thrombosis, and anti-platelet aggregation.Objective To observe the effect of butylphthalide combined with ozagrel sodium on cerebral perfusion and oxidative stress indexes in patients with transient ischemic attack.Methods A total of 116 patients diagnosed as transient ischemic attack in our hospital (February 2018 – February 2020) were selected and divided into two groups according to the treatment methods.  58 cases in the control group were treated with ozagrel sodium, 58 cases in the observation group were treated with butylphthalide combined with ozagrel sodium.The CT perfusion imaging parameters, oxidative stress indexes, plaque area, and the levels of platelet activating factor ( PAF ), α-granule membrane protein-140 ( GMP-140 ), fibrinogen ( FIB ), platelet aggregation rate ( PAgT ), neuron-specific enolase ( NSE ), oxygen-inducible factor-1α ( HIF-1α ), and matrix metalloproteinases-9 ( MMP-9 ) in the two groups were recorded, and the total effective rate and adverse reaction rate were counted.Results The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (χ2 = 4.640, P = 0.031). Compared with before treatment, the average time (MTT) required for the two groups of contrast agents to pass through the local brain tissue and the time (TTP) required to start the injection of contrast agents to reach the peak concentration decreased compared with before treatment. After treatment, the MTT and TTP of the observation group were shorter than those of the control group (P < 0.05).Compared with before treatment, superoxide dismutase ( SOD ) in the two groups was higher than that in the control group, PAF, GMP-140, FIB, PAgT, NSE, HIF-1α, MMP-9, malondialdehyde ( MDA ) and plaque area decreased. After treatment, the levels of related factors in the observation group were better than those in the control group, and the plaque area was less than that in the control group (P < 0.05).There was no significant difference in the adverse reaction rate between the observation group and the control group ( χ2 = 0.438, P = 0.508 ).Conclusion Butylphthalide combined with ozagrel sodium in the treatment of transient ischemic attack can improve cerebral perfusion, reduce oxidative stress injury, reduce plaque and improve curative effect.

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