己酮可可碱缓释片对脑梗死恢复期患者的疗效研究OA

Objective To evaluate the clinical efficacy of sustained-release pentoxifylline tablets in patients with ischemic stroke during the recovery phase.Methods A total of 89 patients with ischemic stroke in the recovery phase were randomly divided into combination therapy group(n=46)and control group(n=43).The control group received conventional antiplatelet therapy,while the combination therapy group was additionally given sustained-release pentoxifylline tablets for 12 weeks.Changes in neurological function,hemorheological parameters,platelet aggregation rates,and related serological indicators were compared between the two groups before treatment and at 2 and 12 weeks of treatment.Adverse events were recorded.Results The overall clinical effective rate in the combination therapy group was significantly higher than that in the control group at 2 and 12 weeks of treatment(P=0.007,P=0.018).With prolonged treatment duration,the overall clinical effective rate of combination therapy group and control group showed an upward trend,and the overall clinical effective rate at 2 and 12 weeks of treatment was statistically significant(P=0.024,P=0.012).There was no significant difference in baseline NIHSS score,mRS score and Barthel index(BI)between the combination therapy group and the control group(all P>0.05).The decrease in NIHSS and mRS scores from baseline in the combination therapy group at 2 weeks after treatment was significantly higher than that in the control group(P=0.021,P=0.005),and there was no significant difference in the change of BI from baseline(P>0.05).There was no significant difference in the changes of NIHSS score,mRS score and BI from baseline between the two groups at 12 weeks after treatment(all P>0.05).Intra-group comparison showed that with the prolongation of treatment time,the decrease of NIHSS score and mRS score in the two groups was larger than that in the baseline,and the increase of BI was larger than that in the baseline,with statistically significant differences(all P<0.001).Compared with those in the control group,the baseline maximum platelet aggregation rate(adenosine diphosphate)in the combination therapy group was significantly increased(P<0.001),and there was no significant difference in other hemorheological indexes and platelet aggregation rate indexes(all P>0.05).Compared with those in the control group,the change of whole blood relative viscosity(low shear)from baseline at 2 weeks after treatment in the combination therapy group had significantly difference(P=0.041),and the change of erythrocyte deformation index from baseline had no significantly difference(P=0.705),the increase of platelet maximum aggregation rate(adenosine diphosphate)from baseline was significantly lower(P=0.044);there was no significant difference in the change of relative viscosity of whole blood(low shear)from baseline at 12 weeks of treatment(P=0.349),the increase of erythrocyte deformation index from baseline was significantly lower(P=0.037),and the increase of maximum platelet aggregation rate(adenosine diphosphate)from baseline was significantly lower(P=0.037).With the prolongation of treatment time,the relative viscosity(low shear)of whole blood in the combination therapy group increased first and then decreased,and the difference between the change of 2 weeks from baseline and 12 weeks from baseline was statistically significant(P=0.001);there was no significant difference between the change of 2 weeks from baseline and 12 weeks from baseline in the control group(P=0.138).The erythrocyte deformation index of the two groups showed an upward trend,and the difference between the change of 2 weeks from baseline and 12 weeks from baseline was statistically significant(P<0.05-0.01).There was no significant difference in the increase of platelet maximum aggregation rate(adenosine diphosphate)at 2 weeks and 12 weeks from baseline between the two groups(all P>0.05).Compared with those in the control group,there was no significant difference in baseline serological indexes in the combination therapy group(all P>0.05).Compared with those in the control group,the serum endothelin level in the combination therapy group was significantly lower at 12 weeks after treatment(P=0.008),and there was no significant difference in prostaglandin and prostacyclin levels(all P>0.05).No adverse events occurred in either group during the treatment period.Conclusion Adjunctive therapy with sustained-release pentoxifylline tablets on the basis of conventional antiplatelet treatment can improve clinical efficacy,neurological function,and hemorheological parameters,as well as reduce endothelin levels,with good safety in patients during the recovery phase of ischemic stroke.