Abstract: Objective　To explore whether butylphthalide can improve the prognosis of patients with acute large-artery atherosclerosis (LAA) cerebral infarction by regulating serum level of lipoprotein-related phospholipase A2 (Lp-PLA2) and carotid intima-media thickness (IMT). Methods　Sixty patients with acute LAA cerebral infarction were recruited and randomly divided into the two groups: the butylphthalide group and the control group, with 30 cases in each group. The butylphthalide group was intravenously injected with butylphthalide injection (100 mL/dose, 2 times/day for 14 days) and received sequential oral butylphthalide soft capsule (0.2 g/dose, 3 times/day for 11.5 months), while the control group was given intravenous drip of normal saline (100 mL/dose, 2 times/day for 14 days). Serum levels of Lp-PLA2, IMT from cervical vascular ultrasound examination and neurological deficit score (NIHSS score) were measured before treatment and 12 months after treatment. Results　The level of Lp-PLA2 in both groups decreased after treatment compared with before treatment (P＜0.05), but the decrease was more obvious in the butylphthalide group than that in the control group (P＜0.01). After 12 months of treatment, IMT was significantly lower in the butylphthalide group than that in the control group (P＜0.05). NIHSS scores were significantly decreased after treatment in the two groups (P＜0.05), but the decrease in the butylphthalide group was more significant (P＜0.01). Conclusion　Butylphthalide treatment can reduce the serum Lp-PLA2 level and alleviate the progression of atherosclerosis so that improve the prognosis of patients with acute LAA cerebral infarction.

Key words: brain infarction, phospholipases A2, 1-alkyl-2-acetylglycerophosphocholine esterase, atherosclerosis, prognosis, butylphthalide