N-Butylphthalide vs. Human Urinary Kallidinogenase for the Treatment of Acute Ischemic Stroke: Functional Outcome and Impact on Serum VEGF and TNF-α Expressions.

Objective: To compare the e!cacy and functional outcomes of dl-3-n-Butylphthalide (NBP) and human urinary kallidinogenase (HUK) on ischemic stroke patients and to determine their effects on serum tumor necrosis factor-alpha (TNF-α) and vascular endothelial growth factor (VEGF).

Methods: A prospective study was conducted on 57 ischemic stroke patients. Functional outcomes were assessed by the National Institute Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the activities of daily living score (ADL), whereas TNF-α and VEGF expressions were measured by enzyme-linked immunosorbent assay (ELISA).

Results: TNF-α was significantly down-regulated in the NBP group and upregulated in the control group two weeks after treatment (=0.017 and =0.047, respectively). A significant difference in VEGF expressions was observed between the two groups (330.25±120.64 vs. 437.15±137.68, =0.041) two weeks after treatment. Both groups showed significant improvement in NIHSS and ADL scores three months after treatment (<0.001), with the NBP group exhibiting improvement in NIHSS scores as early as two weeks after treatment (=0.008). The three-month NIHSS scores of the two groups were significantly lower than those of the control group (=0.010 and =0.008, respectively). Both the NBP and HUK groups showed a significant decline in mRS scores two weeks and three months after treatment (<0.05).

Conclusions: Both treatments are effective and can significantly promote recovery in stroke patients. Additionally, both options have similar effects in promoting long-term recovery, with NBP exerting a greater impact on serum VEGF and TNF-α expressions.