Therapeutic Efficacy of Persimmon Leaf Flavonoids Extract in Ischemic Cerebrovascular Disease

Abstract

In this research, the effects of persimmon leaf extract in treating ischemic cerebrovascular disease (ICVD) were analyzed, and the therapeutic outcomes were evaluated using techniques such as computed tomography (CT) angiography. Firstly, the impact of extraction conditions on the yield of flavonoids from persimmon leaves was assessed, and their scavenging rates (SRs) against three types of free radicals (DPPH, hydroxyl, and superoxide anion) were measured. Subsequently, 80 patients with ICVD were enrolled. Before treatment, patients’ carotid artery atherosclerotic plaque composition was evaluated using gemstone spectral CT, and the effects of conventional therapy (Ctrl group) were compared with those of treatment using persimmon leaf extract (Test group) on the patients’ blood lipids (BLs), blood glucose (BG) levels, hemorheology, hemodynamics, and CT angiography/perfusion imaging characteristics. Additionally, the post-treatment recurrence rate was recorded. The results revealed that the solvent concentration, ultrasonic power, temperature, time, and solid-liquid ratio markedly influenced the yield of persimmon leaf extract. Furthermore, the persimmon leaf extract demonstrated remarkable efficacy in scavenging three types of free radicals, namely DPPH, hydroxyl, and superoxide anion. The clinical results demonstrated that the main components of carotid artery plaque in ICVD patients were lipids, fibrous matrix, and hemorrhage, and the spectral curve combined with CT values accurately differentiated these plaque components. Patients in Test group exhibited notable improvements versus Ctrl group (P <0.05) in their serum lipid profiles (reduced total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels, increased low-density lipoprotein cholesterol (LDL-C) levels), BG levels (decreased fasting BG (FBG), glycosylated hemoglobin (HbA1c), and postprandial 2-hour BG (2h-PG) levels), hemorheological parameters (decreased low-shear whole blood viscosity (LSBV), high-shear whole blood viscosity (HSBV), blood viscosity (PV), packed cell volume (PCV), platelet adhesion rate (PAR), and fibrinogen (FIB) levels), transcranial Doppler ultrasound parameters (increased mean blood flow velocity (Vm), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of middle cerebral artery (CA), anterior CA, and basilar artery), and CT angiography with perfusion imaging parameters (increased cerebral blood flow (rCBF) and region cerebral blood volume (rCBV), shortened time to peak (TTP)). Additionally, recurrence rates of transient ischemic attack and cerebral infarction were lower in Test group compared to Ctrl group. In summary, the findings suggest that persimmon leaf extract possesses potent antioxidant properties. Spectral CT can identify and distinguish carotid artery plaque components. Furthermore, persimmon leaf extract effectively improved blood lipids, blood pressure, hemorheology, hemodynamics, and cerebral perfusion status, thereby reducing the risk of recurrence in ICVD.