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人参皂苷 Rd 改善急性缺血性脑卒中的预后 - 一项随机、双盲、安慰剂对照、多中心试验。

Ginsenoside-Rd improves outcome of acute ischaemic stroke - a randomized, double-blind, placebo-controlled, multicenter trial.

机构信息

Department of Neurology, Xijing Hospital, Xi'an, China.

出版信息

Eur J Neurol. 2012 Jun;19(6):855-63. doi: 10.1111/j.1468-1331.2011.03634.x. Epub 2012 Jan 10.

Abstract

BACKGROUND AND PURPOSE

Ginsenoside-Rd is a receptor-operated calcium channel antagonist and has shown promise as a neuroprotectant in our phase II study. As an extended work, we sought to confirm its efficacy and safety of Ginsenoside-Rd in patients with acute ischaemic stroke.

METHODS

We conducted a randomized, double-blind, placebo-controlled trial involving 390 patients with acute ischaemic stroke in a 3:1 ratio to receive a 14-day intravenous infusion of Ginsenoside-Rd or placebo within 72 h after the onset of stroke. Our primary end-point was the distribution of disability scores on the modified Rankin scale (mRs) at 90 days.

RESULTS

The efficacy analysis was based on 386 patients (Ginsenoside-Rd group: 290; placebo group: 96). Ginsenoside-Rd significantly improved the overall distribution of scores on the mRs, as compared with the placebo (P = 0.02; odds ratios [OR], 1.74; 95% confidence interval [CI], 1.08-2.78). There were significant differences between the two groups when we categorized the scores into 0-1 vs. 2-5 (P = 0.01; OR, 2.32; 95% CI, 1.23-4.38; 66.8% vs. 53.1%). It also improved the National Institutes of Health Stroke Scale (NIHSS) at 15 days [P < 0.01; least squares mean (LSM), -0.77; 95% CI, -1.31 to -0.24]. Mortality and rates of adverse events were similar in the two groups.

CONCLUSIONS

Ginsenoside-Rd improved the primary outcome of acute ischaemic stroke and had an acceptable adverse-event profile.

摘要

背景与目的

人参皂苷-Rd 是一种受体操纵型钙通道拮抗剂,在我们的 II 期研究中已显示出作为神经保护剂的潜力。作为一项扩展工作,我们旨在确认人参皂苷-Rd 在急性缺血性脑卒中患者中的疗效和安全性。

方法

我们进行了一项随机、双盲、安慰剂对照试验,纳入了 390 例急性缺血性脑卒中患者,按照 3:1 的比例,在发病后 72 小时内接受 14 天的静脉注射人参皂苷-Rd 或安慰剂治疗。我们的主要终点是 90 天时改良 Rankin 量表(mRs)的残疾评分分布。

结果

疗效分析基于 386 例患者(人参皂苷-Rd 组 290 例,安慰剂组 96 例)。与安慰剂相比,人参皂苷-Rd 显著改善了 mRs 的总体评分分布(P=0.02;优势比[OR],1.74;95%置信区间[CI],1.08-2.78)。当我们将评分分为 0-1 与 2-5 时,两组之间存在显著差异(P=0.01;OR,2.32;95%CI,1.23-4.38;66.8%比 53.1%)。它还改善了 15 天时的国立卫生研究院卒中量表(NIHSS)评分[P<0.01;最小二乘均数(LSM),-0.77;95%CI,-1.31 至-0.24]。两组的死亡率和不良事件发生率相似。

结论

人参皂苷-Rd 改善了急性缺血性脑卒中的主要结局,且具有可接受的不良事件谱。

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