EFFECT OF HEPARIN-INDUCED EXTRACORPOREAL LOW-DENSITY-LIPOPROTEIN PRECIPITATION AND BEZAFIBRATE ON HEMORHEOLOGY AND CLINICAL SYMPTOMS IN CEREBRAL MULTIINFARCT DISEASE

The effects of heparin-mediated extracorporeal low-density lipoprotein (total cholesterol, lipoprotein (a), triglycerides, fibrinogen) preci pitation (HELP) and bezafibrate on fibrinogen, metabolic parameters, h emorheological patterns and clinical symptoms were studied in 40 patie nts suffering from cerebral multiinfarct disease. After a single HELP application, the patients were randomly assigned to two groups, either receiving sustained-release bezafibrate 400 mg (n = 21) or placebo (n = 19) over a period of 8 weeks. In all cases, HELP led to a statistic ally significant reduction of fibrinogen (p < 0.0001) and other parame ters relevant to hemorheology, this effect, however, only being retain ed in the bezafibrate group. Parallel to this development, the Mathew scale revealed an improvement after HELP (p < 0.01 in each group) with a further improvement in the bezafibrate group (p < 0.05). The Mini M ental State Examination also showed improved results after HELP (p < 0 .0005 and p < 0.03, respectively), a further improvement being observe d in the bezafibrate group (p < 0.05). Comparing the day after HELP tr eatment to that at the end of the study, the Activities of Daily Livin g Score showed a statistically significant difference in the fibrate g roup (p < 0.05). These results support the hypothesis that the improve d hemorheologic property of blood is an important factor in clinical r ecovery as well as basic neurologic function.