Administration of Cilostazol, an Antiplatelet, to Patients with Acute-stage Cerebral Infarction and Its Effects on Plasma Substance P Level and Latent Time of Swallowing Reflex
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- Abe Arata
- Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
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- Nishiyama Yasuhiro
- Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
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- Hagiwara Hiroshi
- Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
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- Okubo Seiji
- Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
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- Ueda Masayuki
- Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
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- Katsura Ken-ichiro
- Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
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- Katayama Yasuro
- Divisions of Neurology, Nephrology, and Rheumatology, Department of Internal Medicine, Nippon Medical School
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Background and Objective: It has been reported that medical treatment with cilostazol (cilo) as an antiplatelet may increase a substance P level in the striatum to shorten the latent time of swallowing reflex (LTSR). We undertook a pilot study to confirm whether cilo administration to patients with cerebral infarction is effective in increasing their plasma substance P level and then in ameliorating the status of LTSR.<br> Methods and Subjects: Eligible subjects were recruited, after informed consents, from 20 hospitalized patients with acute-phase cerebral infarction within 72 hours from the onset. At the start of treatment, the subjects were assigned at random to those given aspirin alone (non-cilo group) and those given aspirin plus cilo (cilo group). Plasma substance P levels and LTSR values were measured at the starting point (baseline), 28 days after, and 180 days after.<br> Results and Discussion: No significant time-dependent change in plasma substance P level was found probably because of large individual differences but, 28 days after the start of treatment, this value tended to become higher in cilo group than in non-cilo group (P<0.10). Whereas, in terms of fold changes of LTSR in cilo group, there was a significant between-term difference at P<0.05, indicating that this medication is effective in ameliorating the swallowing function is improved in the long run.<br> Conclusion: The LTSR values was significantly shortened within 180 days after the start of cilo treatment, but the result was not well explained by substance P levels as far as these were measured using the plasma, probably because this substance had diluted during blood circulation. However, it will become clinically usable as a single swallowing index, if in the future some ingeneus method of its measurement is developed. A larger-scale study would also be needed to confirm our conclusion from this pilot study.<br>
収録刊行物
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- 日医大誌
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日医大誌 80 (1), 50-56, 2013
日本医科大学医学会