Zheng J, Chen X
Department of Neurology, Shanghai Eighth Hospital, Jiangsu University, 8 Caobao Road, Shanghai, 200235, China.
Ir J Med Sci. 2016 Nov;185(4):819-824. doi: 10.1007/s11845-015-1371-9. Epub 2015 Nov 23.
Edaravone, a novel free-radical scavenger, has been shown to alleviate cerebral ischemic injury and protect against vascular endothelial dysfunction. However, the effects of edaravone in acute diabetic stroke patients remain undetermined.
A randomized, double-blind, placebo-controlled study was performed to prospectively evaluate the effects of edaravone on acute diabetic stroke patients admitted to our hospital within 24 h of stroke onset. The edaravone group received edaravone (30 mg twice per day) diluted with 100 ml of saline combined with antiplatelet drug aspirin and atorvastatin for 14 days. The non-edaravone group was treated only with 100 ml of saline twice per day combined with aspirin and atorvastatin. Upon admission, and on days 7, 14 post-stroke onset, neurological deficits and activities of daily living were assessed using the National Institutes of Health Stroke Scale (NIHSS) and the Barthel Index (BI), respectively. The occurrence of hemorrhage transformation, pulmonary infection, progressive stroke and epilepsy was also evaluated on day 14 post-treatment.
A total of 65 consecutive acute diabetic stroke patients were enrolled, of whom 35 were allocated to the edaravone group and 30 to the non-edaravone group. There was no significant group difference in baseline clinical characteristics, but mean NIHSS scores were lower (60 %), and BI scores were 1.7-fold higher, in edaravone-treated patients vs. controls on day 14. Furthermore, the incidence of hemorrhage transformation, pulmonary infection, progressive stroke and epilepsy was markedly reduced in the edaravone vs. non-edaravone group.
Edaravone represents a promising neuroprotectant against cerebral ischemic injury in diabetic patients.
依达拉奉是一种新型自由基清除剂,已被证明可减轻脑缺血损伤并预防血管内皮功能障碍。然而,依达拉奉在急性糖尿病性卒中患者中的作用仍未明确。
进行了一项随机、双盲、安慰剂对照研究,以前瞻性评估依达拉奉对卒中发作24小时内入住我院的急性糖尿病性卒中患者的影响。依达拉奉组接受用100ml生理盐水稀释的依达拉奉(每日两次,每次30mg)联合抗血小板药物阿司匹林和阿托伐他汀治疗14天。非依达拉奉组仅接受每日两次100ml生理盐水联合阿司匹林和阿托伐他汀治疗。入院时以及卒中发作后第7天、第14天,分别使用美国国立卫生研究院卒中量表(NIHSS)和巴氏指数(BI)评估神经功能缺损和日常生活活动能力。治疗后第14天还评估了出血转化、肺部感染、进展性卒中和癫痫的发生情况。
共纳入65例连续的急性糖尿病性卒中患者,其中35例被分配到依达拉奉组,30例被分配到非依达拉奉组。基线临床特征在两组之间无显著差异,但在第14天,依达拉奉治疗的患者与对照组相比,平均NIHSS评分较低(低60%),BI评分高1.7倍。此外,依达拉奉组与非依达拉奉组相比,出血转化、肺部感染、进展性卒中和癫痫的发生率明显降低。
依达拉奉是一种有前景的针对糖尿病患者脑缺血损伤的神经保护剂。