Mitta Manish, Goel Deepak, Bansal Krishan K, Puri Prashant
Department of General Medicine, HIHT University, Swami Ram Nagar, Doiwala, Dehradun.
J Assoc Physicians India. 2012 Nov;60:36-8.
Two new neuro-protective agents, Edaravone and Citicoline were recently found to be beneficial in acute ischemic stroke (AIS). But there is no study to compare these two agents on same protocol in AIS. This study was aimed to compare these two neuroprotective agents in AIS.
All patients of age more than 18 years who presented within 24 hours of acute ischemic stroke were randomly treated with Edaravone (group E), Citicoline (group C) or none (group N) with other standard treatment of AIS. Modified Rankin Scale (MRS) and National Institute of Health Stroke Scale (NIHSS) were recorded on admission and at 3 months. Analysis was done using Anova t test to find out significant difference in outcome at 3 months. P value of < or = 0.05 was labeled as significant.
Mean MRS and NIHSS scores at 3 months were lowest in group E (p = 0.000), suggestive of better outcome in this group. After application of severity scale, 15 patients (68.1%) in group-E, 14 (58.3%) in group C and 18 (72%) in group N had moderate to severe stroke (NIHSS of more than 10). When the patients of moderate to severe stroke were analyzed separately at 3 months, patients in group E (mean 4.46 +/- 3.52) had significantly (p = 0.00) better outcome in comparison to group C (mean 10.28 +/- 7.93) and group N (mean 9.38 +/- 6.44).
Edaravone was found to be associated with better neurological outcome at 3 months. Citicoline's role as a neuroprotective agent however remains controversial in acute ischaemic stroke.
最近发现两种新型神经保护剂依达拉奉和胞磷胆碱对急性缺血性卒中（AIS）有益。但尚无研究在相同方案下比较这两种药物在AIS中的疗效。本研究旨在比较这两种神经保护剂在AIS中的疗效。
所有年龄超过18岁、在急性缺血性卒中发病24小时内就诊的患者，在接受AIS其他标准治疗的同时，随机接受依达拉奉治疗（E组）、胞磷胆碱治疗（C组）或不接受治疗（N组）。在入院时和3个月时记录改良Rankin量表（MRS）和美国国立卫生研究院卒中量表（NIHSS）。采用方差分析t检验进行分析，以找出3个月时结局的显著差异。P值≤0.05被视为具有显著性。
E组3个月时的平均MRS和NIHSS评分最低（p = 0.000），提示该组预后较好。应用严重程度量表后，E组15例患者（68.1%）、C组14例患者（58.3%）和N组18例患者（72%）为中度至重度卒中（NIHSS评分超过10分）。对中度至重度卒中患者在3个月时进行单独分析，与C组（平均10.28±7.93）和N组（平均9.38±6.44）相比，E组患者（平均4.46±3.52）的预后显著更好（p = 0.00）。
发现依达拉奉与3个月时更好的神经学结局相关。然而，胞磷胆碱作为神经保护剂在急性缺血性卒中中的作用仍存在争议。
