Ohta Yasuyuki, Takamatsu Kazuhiro, Fukushima Tomoko, Ikegami Satomi, Takeda Ikuko, Ota Taisei, Goto Katsuya, Abe Koji
Ota Memorial Hospital, Fukuyama, Japan.
Intern Med. 2009;48(8):593-6. doi: 10.2169/internalmedicine.48.1871. Epub 2009 Apr 15.
Free radicals are important in causing neural cell injury during cerebral infarction. Although there was a randomized, placebo-controlled, double-blind study at multiple centers in Japan showing the efficacy of the free radical scavenger, edaravone, in acute cerebral infarction, to date the clinical studies are few. This study investigated the effect of edaravone on the outcome of patients with acute lacunar infarction.
We retrospectively evaluated 124 consecutive patients with first-ever acute lacunar infarctions who were admitted to our hospital within 24 hours after the onset between January 2004 and June 2007. Of these, 59 patients received both edaravone and conventional therapy (edaravone group), and the other 65 underwent conventional therapy only (non-edaravone group). There was no significant difference in patients' baseline characteristics in the two groups. The clinical outcome was assessed by the National Institutes of Health Stroke Scale (NIHSS).
The reduction of NIHSS scale during hospitalization (1.5+/-1.0 vs. 1.0+/-1.1; p = 0.007), especially that of the motor palsy scale (1.0+/-1.0 vs. 0.5+/-1.0; p = 0.006) was significantly larger, and the percentage of patients with a favorable outcome (NIHSS at discharge < or =1) (91.5% vs. 78.5%; p = 0.044) was significantly better in the edaravone group.
Edaravone improves the outcomes of patients with acute lacunar infarction, especially motor palsy, without regard to the conventional therapy performed concomitantly.
自由基在脑梗死期间导致神经细胞损伤方面起着重要作用。尽管日本多个中心进行的一项随机、安慰剂对照、双盲研究表明自由基清除剂依达拉奉对急性脑梗死有效,但迄今为止临床研究较少。本研究调查了依达拉奉对急性腔隙性脑梗死患者预后的影响。
我们回顾性评估了2004年1月至2007年6月期间发病后24小时内入院的124例首次发生急性腔隙性脑梗死的连续患者。其中,59例患者接受了依达拉奉和常规治疗(依达拉奉组),另外65例仅接受常规治疗(非依达拉奉组)。两组患者的基线特征无显著差异。临床结局通过美国国立卫生研究院卒中量表(NIHSS)进行评估。
住院期间NIHSS量表的降低幅度(1.5±1.0对1.0±1.1;p = 0.007),尤其是运动麻痹量表的降低幅度(1.0±1.0对0.5±1.0;p = 0.006)明显更大,依达拉奉组预后良好(出院时NIHSS≤1)的患者百分比(91.5%对78.5%;p = 0.044)明显更好。
依达拉奉可改善急性腔隙性脑梗死患者的预后,尤其是运动麻痹,且与同时进行的常规治疗无关。