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甲泼尼龙与地塞米松治疗颅内肿瘤水肿的临床对照试验

[Clinical control trial of methylprednisolone and dexamethasone in treatment of intracranial tumor edema].

作者信息

Ding Xinmin, Mao Boyong, Ju Yan, Liu Yanhui

机构信息

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2003 Apr;34(2):327-9.

Abstract

OBJECTIVE

This study was designed to evaluate the therapeutic effect and side effect of methylprednisolone on brain tumor edema.

METHODS

Fifty-eight patients with brain tumor edema revealed by CT/MRI were randomly divided into two groups. 30 patients of trial group were treated with methylprednisolone, and 28 patients of the control group received dexamethasone for 3-5 days before and after operation. The patients' clinical neurological symptoms and signs were observed at the beginning and end of treatment before operation, and Karnofsky Performance Scores, were given to the case. Furthermore, the patients' cell immunity, electrolytes, blood sugar that might be affected, by methylprednisolone and dexamethasone were investigated concerned.

RESULTS

Nineteen of 30 patients taking methylprednisolone and seventeen of 28 patients taking dexamethasone showed improvement in their clinical neurological symptoms, total effective rates for methylprednisolone and dexamethasone groups were 63.0% and 60.7% respectively, there was no obvious difference between the two groups in this regard rate (P > 0.05). Furthermore nine patients (30.0%) in trial group show significant improvement, whereas only four patients (14.3%) in the control group show significant improvement, the difference here was statistically significant (P < 0.05). There was no obvious side effect in both groups during treatment.

CONCLUSION

Vasogenic edema associated with brain tumor and its induced symptoms was effectively treated by methylprednisolone without adverse effects, Current findings suggest that further study of methylprednisolone in the management of control nervous system tumors is warranted.

摘要

目的

本研究旨在评估甲泼尼龙对脑肿瘤水肿的治疗效果及副作用。

方法

58例经CT/MRI显示有脑肿瘤水肿的患者被随机分为两组。试验组30例患者接受甲泼尼龙治疗,对照组28例患者在手术前后接受地塞米松治疗3 - 5天。在治疗开始时、手术前及治疗结束时观察患者的临床神经症状和体征,并对病例进行卡诺夫斯基功能状态评分。此外,还研究了甲泼尼龙和地塞米松可能影响的患者细胞免疫、电解质、血糖情况。

结果

服用甲泼尼龙的30例患者中有19例、服用地塞米松的28例患者中有17例临床神经症状有所改善,甲泼尼龙组和地塞米松组的总有效率分别为63.0%和60.7%,两组在这方面的有效率无明显差异(P > 0.05)。此外,试验组有9例患者(30.0%)有显著改善,而对照组只有4例患者(14.3%)有显著改善,此处差异有统计学意义(P < 0.05)。两组治疗期间均无明显副作用。

结论

甲泼尼龙可有效治疗与脑肿瘤相关的血管源性水肿及其引发的症状,且无不良反应。目前的研究结果表明,有必要进一步研究甲泼尼龙在控制神经系统肿瘤方面的作用。

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