Objective  To study the effectiveness of butylphthalide injection on acute cerebral in-farction (AIS) patients based on Trial of Org 10172 in Acute Stroke Treatment subtypes (TOAST classifi-cation).

Methods  Cases suffered from AIS admitted between January 2018 and December 2020, without thrombectomy or thrombolysis therapy, were included and classified according to TOAST class-fication criteria. Clinical data and efficacy indicators of patients with different classifications were com-pared.

Results  A total of 216 patients were included, including 104 cases (48.15%) of LAA sub-tupe, 94 cases (43.52%) of SAO sub-tupe and 18 cases (8.33%) of CE sub-type. Posterior circulation infarct accounted for 49.04% and 61.70% of patients with large artery atherosclerosis (LAA) and small artery occlusion (SAO) and anterior circulation infarct accounted for 83.33% of patients with cardioembolism (CE) with the significant difference in infarction area (P<0.05). After butylphthalide injection treatment, the rate of collateral circulation was significant improved in LAA, SAO and CE sub-types (P<0.05). Na-tional Institute of Health Stroke Scale (NIHSS) score was observed with significant decreases in all sub-types (P<0.05), whereas Barthel Index (BI) was increased, respectively (P<0.05). By butylphthalide therapy within 24 h, there were significant increases in LAA and SAO sub-types than other periods (P<0.05). After butylphthalide treatment, high-sensitive C-reactive protein (hs-CRP) was notably de-creased in the three sub-types (P<0.05), and IL-6 was also decreased (P<0.05).

Conclusion  Bu-tylphthalide injection could benefit acute cerebral infarction patients with TOAST classification and also improve inflammatory damage, and the highest effective rates could be achieved by butylphthalide in-jection within 24 hours.

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