Effect of Erigeron breviscapus on collateral circulation in patients with ischemic stroke

Abstract

Objective To explore the mechanism of Erigeron breviscapus on improving cerebral circulation in patients with ischemic stroke by observing the formation of collateral circulation using CT perfusion imaging （CTP）. Methods Sixty ischemic stroke patients were selected and randomly divided into the treatment （n = 32） and control groups （n = 28）. During the study, there were 3 patients dropped in the treatment group and 2 patients dropped in the control group. Finally, there were 29 cases enrolled in the treatment group and 26 cases enrolled in the control group. All patients in two groups received routine treatment. In the treatment group, intravenous injection of Erigeron breviscapus was given for 2 weeks, and an equivalent amount of normal saline was administered for 2 weeks in the control group. CTP was performed at 1 d after admission （before treatment） and 30 d after admission. Time-point measurement of cerebral blood flow （CBF）, cerebral blood volume （CBV）, time to the peak （TTP） and mean transit time （MMT） of the region of interest （ROI） on the affected side was recorded. Serum levels of vascular endothelial growth factor （VEGF）, hypoxia inducible factor-1α （HIF-1α）, angiopoietin -1 （Ang-1） were detected before and 14 d after treatment, and 30 d after admission, respectively. The National Institute of Health Stroke Scale （NIHSS） and Barthel index （BI） scores were measured. All these indexes were statistically compared between two groups. Results In both groups, CBF and CBV were significantly increased, whereas TTP and MMT at 30 d after admission were significantly shortened compared with those before treatment （all P < 0.05）. In the treatment group, the expression levels of serum VEGF and Ang-1 at 14 d after treatment were significantly up-regulated, whereas significantly down-regulated at 30 d after admission compared with those before treatment, and the expression level of HIF-1α was gradually down-regulated （all P < 0.017）. At 14 d after treatment and 30 d post-admission, the NIHSS score was significantly lower, where the BI score was significantly higher in the treatment group compared with those in the control group （both P < 0.05）. Conclusion Erigeron breviscapus can promote collateral circulation formation, alleviate neurological deficits and improve daily living ability in patients with ischemic stroke, which may be associated with dynamic changes of VEGF, HIF-1α and Ang-1, especially the Ang-1.

Keywords

• |collateral circulation|erigeron breviscapus|stroke|ct perfusion imaging|cytokine