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静脉注射硫酸镁对急性缺血性中风患者临床改善效果的评估。

Evaluation of the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke.

作者信息

Afshari Daryoush, Moradian Nasrin, Rezaei Mansour

机构信息

Neurology Department of Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Clin Neurol Neurosurg. 2013 Apr;115(4):400-4. doi: 10.1016/j.clineuro.2012.06.001. Epub 2012 Jun 30.

Abstract

BACKGROUND

Evidence is mounting that magnesium may play a critical role in the development of strokes and the healing process during and after a stroke. Magnesium is an N-methyl-D-aspartate (NMDA) glutamate receptor antagonist that has been shown to be neuroprotective in many preclinical models of ischemic and excitotoxic brain injury. This study was performed to evaluate the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke.

METHODS

One hundred and seven patients with acute ischemic stroke signs and symptoms lasting less than 12 hours were included in the study and were divided into two groups, 55 patients received 4 g of MgSO(4) over 15 minutes and then 16 g over the next 24 hours, and 52 patients were received matching placebo. The study primary end point was stroke related neurologic deficit evaluation by the national institute of stroke scale (NIHSS).

RESULTS

Patients receiving MgSO(4) showed significant recovery compared with the group of patients receiving placebo.

CONCLUSION

This study suggests that magnesium sulfate can be used as a safe and useful neuroprotective agent in acute ischemic stroke and lacunar stroke patients may represent a relevant and practical target population for agents with biological activity in white matter.

摘要

背景

越来越多的证据表明,镁在中风的发生发展以及中风期间及之后的愈合过程中可能起着关键作用。镁是一种N-甲基-D-天冬氨酸(NMDA)谷氨酸受体拮抗剂,在许多缺血性和兴奋性毒性脑损伤的临床前模型中已显示具有神经保护作用。本研究旨在评估静脉注射硫酸镁对急性缺血性中风患者临床改善的效果。

方法

107例急性缺血性中风体征和症状持续时间少于12小时的患者纳入研究,分为两组,55例患者在15分钟内静脉注射4克硫酸镁,随后在接下来的24小时内静脉注射16克;52例患者接受匹配的安慰剂。研究的主要终点是通过国立卫生研究院卒中量表(NIHSS)对中风相关神经功能缺损进行评估。

结果

与接受安慰剂的患者组相比,接受硫酸镁治疗的患者显示出明显的恢复。

结论

本研究表明,硫酸镁可作为急性缺血性中风安全有效的神经保护剂,腔隙性中风患者可能是对白质具有生物活性药物的相关实用目标人群。

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