Effects of butylphthalide combined with tenecteplase on clinical prognosis and serum sST2 levels in patients with acute ischemic stroke

LI Hong; MU Shanshan

doi:10.3969/j.issn.2097-1753.2025.04.011

Abstract：Objective To evaluate the effects of butylphthalide combined with tenecteplase on levels of serum sST2 and other cytokines as well as on neurological functional outcomes in patients with acute ischemic stroke.Methods A prospective study was conducted on 108 acute ischemic stroke(AIS)patients eligible for intravenous thrombolysis treated between June 2023 and June 2024 at the Third Department of Critical Care Medicine.Using a random number table method,these patients were assigned to two groups:the butylphthalide group(n=54,tenecteplase+butylphthalide)and the control group(n=54,tenecteplase alone).Serum levels of soluble suppression of tumorigenicity 2(sST2),matrix metalloproteinase-9(MMP-9),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)were measured before treatment(post-thrombolysis)and 14 days after treatment.Neurological function was assessed using the National Institutes of Health Stroke Scale(NIHSS),functional prognosis was assessed by the Modified Rankin Scale(mRS)and such complications as intracranial hemorrhage were recorded.Results The NIHSS scores of both groups kept decreasing at 24 hours,7 days,and 14 days after treatment(all P＜0.001).At 14 days post-treatment,neurological recovery in the butylphthalide group was better than in the control group(P=0.011).In addition,more patients in the butylphthalide group had favorable short-term(14-day)neurological outcomes(mRS≤2)than in the control group(χ2=4.123,P=0.042).During the long-term follow-up(90 days),the rate of favorable functional outcomes(mRS≤2)was higher in the butylphthalide group than in the control group(χ2=4.160,P=0.041).No statistically significant difference was observed in the incidence of hemorrhagic transformation between the two groups(P＞0.05).At 14 days post-treatment,the levels of the cytokines sST2,MMP-9,IL-6,and hs-CRP in the butylphthalide group were significantly lower than in the control group(Z=2.173～3.160,all P＜0.05).Conclusion Butylphthalide combined with tenecteplase can effectively mitigate inflammatory responses in AIS patients,significantly reduce serum levels of sST2 and related pro-inflammatory factors while promoting neurological recovery without increasing hemorrhagic risk.