Effect of salvianolic acid combined with urinary kallidinogenase on cognitive function, cerebral hemodynamics and serum LPA, ox-LDL, MMP-9 levels in patients with acute cerebral watershed infarction

doi:10.3877/cma.j.issn.2095-123X.2023.03.003

Abstract

Abstract:

Objective

To investigate the clinical effect of salvianolic acid combined with urinary kallidinogenase on acute cerebral watershed infarction (ACWI) and its influence on cognitive function, cerebral hemodynamics and serum levels of lysophosphatidic acid (LPA), oxidized low density lipoprotein (ox-LDL), matrix metalloproteinases-9 (MMP-9).

Methods

Eighty patients with ACWI admitted to General Medicine Department of 928 Hospital of PLA Joint Logistic Support Force from January 2019 to June 2021 were randomly divided into observation group and control group (40 cases each). The control group was treated with urinary kallidinogenase, and the observation group was treated with salvianolic acid. All subjects were treated continuously for 3 weeks after the observation of the clinical efficacy of the two groups. The scores of montreal cognitive assessment (MoCA), national institute of health stroke scale (NIHSS), the peak systolic velocity (Vp) and resistance index (RI) of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and vertebral artery (VA), and the levels of LPA, ox-MMP-9 were compared between the two groups before and after treatment. The adverse reactions of the two groups were also analyzed.

Results

The total effective rate of the observation group (92.50%) was higher than that of the control group (75.00%), and the difference was statistically significant (P<0.05). The MoCA subitem scores and total scores of the two groups after treatment were significantly higher than those before treatment, and the observation group showed greater improvement (P<0.05). Compared with before treatment, NIHSS score and RI of ACA, MCA and VA in the two groups after treatment were decreased, and Vp of ACA, MCA and VA were increased, and NIHSS score and RI of ACA, MCA and VA in the observation group were lower than those in the control group, and Vp of ACA, MCA and VA in the observation group were significantly higher than those in the control group (P<0.05). The serum concentrations of LPA, ox-LDL and MMP-9 in the two groups after treatment were significantly lower than those before treatment, and those in the observation group was lower than those 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 (P>0.05).

Conclusion

The overall effect of salvianolic acid combined with urinary kallidinogenase in the treatment of ACWI is definite, which can safely and effectively relieve the patients' neurological deficit and improve their cognitive function, it can further improve the expression level of LPA, ox-LDL and MMP-9 in the brain hemodynamics and down-regulate the blood.

Key words: Acute cerebral watershed infarction, Salvianolic acid, Urinary kallidinogenase, Cognitive function, Hemodynamics

Shanshan Wang, Xiaoru Xu, Zhenxian Shi, Dejie Zhang. Effect of salvianolic acid combined with urinary kallidinogenase on cognitive function, cerebral hemodynamics and serum LPA, ox-LDL, MMP-9 levels in patients with acute cerebral watershed infarction[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(03): 142-149.

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References 23

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项目	观察组（n=40）	对照组（n=40）	χ²/t值	P值
性别			0.052	0.820
男	23	24
女	17	16
年龄（岁，Mean±SD）	64.87±9.73	63.79±10.24	0.484	0.630
发病至入院时间（h，Mean±SD）	16.44±4.68	15.82±4.10	0.630	0.530
合并危险因素
高血压	19	21	0.200	0.655
2型糖尿病	12	11	0.061	0.805
血脂异常	14	12	0.228	0.633
冠心病	5	7	0.392	0.531
吸烟	9	10	0.069	0.793
临床分型			0.207	0.902
皮质型	8	7
皮质下型	13	12
混合型	19	21

项目	观察组（n=40）	对照组（n=40）	χ²/t值	P值
性别			0.052	0.820
男	23	24
女	17	16
年龄（岁，Mean±SD）	64.87±9.73	63.79±10.24	0.484	0.630
发病至入院时间（h，Mean±SD）	16.44±4.68	15.82±4.10	0.630	0.530
合并危险因素
高血压	19	21	0.200	0.655
2型糖尿病	12	11	0.061	0.805
血脂异常	14	12	0.228	0.633
冠心病	5	7	0.392	0.531
吸烟	9	10	0.069	0.793
临床分型			0.207	0.902
皮质型	8	7
皮质下型	13	12
混合型	19	21

组别	例数	基本痊愈	显著进步	进步	无变化	恶化	总有效率[例（%）]
观察组	40	6	20	11	3	0	37（92.50）
对照组	40	4	13	13	10	0	30（75.00）
Z/χ²值		-2.180					4.501
P值		0.029					0.034

组别	例数	基本痊愈	显著进步	进步	无变化	恶化	总有效率[例（%）]
观察组	40	6	20	11	3	0	37（92.50）
对照组	40	4	13	13	10	0	30（75.00）
Z/χ²值		-2.180					4.501
P值		0.029					0.034

项目		观察组（n=40）	对照组（n=40）	t值	P值
视空间/执行功能	治疗前	2.74±0.71	2.85±0.65	0.723	0.472
	治疗后	4.73±0.22	4.38±0.57	3.623	0.001
	t值	16.932	11.193
	P值	<0.001	<0.001
注意力	治疗前	3.76±0.95	3.91±1.08	0.660	0.511
	治疗后	5.69±0.25	5.35±0.59	3.356	0.001
	t值	12.426	7.400
	P值	<0.001	<0.001
抽象思维	治疗前	0.98±0.25	0.93±0.22	0.950	0.345
	治疗后	1.75±0.20	1.62±0.24	2.632	0.010
	t值	15.211	13.404
	P值	<0.001	<0.001
延迟回忆	治疗前	2.16±0.57	2.02±0.61	1.061	0.292
	治疗后	4.24±1.03	3.66±0.95	2.618	0.011
	t值	11.175	9.187
	P值	<0.001	<0.001
命名	治疗前	2.01±0.55	1.92±0.50	0.766	0.446
	治疗后	2.69±0.24	2.32±0.36	5.408	<0.001
	t值	7.167	4.106
	P值	<0.001	<0.001
语言	治疗前	1.73±0.45	1.86±0.52	1.196	0.235
	治疗后	2.45±0.36	2.13±0.45	3.512	0.001
	t值	7.902	2.483
	P值	<0.001	0.015
定向力	治疗前	4.15±1.16	4.27±1.04	0.487	0.627
	治疗后	5.33±0.52	4.73±0.71	4.312	<0.001
	t值	5.871	2.310
	P值	<0.001	0.023
总分	治疗前	17.73±4.37	18.06±4.75	0.323	0.747
	治疗后	27.14±2.09	24.25±4.32	3.809	<0.001
	t值	12.286	6.097
	P值	<0.001	<0.001

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