Department of Neurosurgery, Huashan Hospital, Fudan University , Shanghai, People's Republic of China .
J Neurotrauma. 2017 Oct 1;34(19):2753-2759. doi: 10.1089/neu.2017.5033. Epub 2017 Jul 19.
Deferoxamine mesylate can cross the blood-brain barrier and reduce iron accumulation in nervous tissue; moreover, it has a variety of neuroprotective functions in addition to complexing with iron ions. Such iron chelators are expected to become a new treatment option for intracerebral hemorrhage. This study evaluated the effects of deferoxamine mesylate on hematoma and edema absorption after traumatic intracerebral hemorrhage (TICH), and it provides clinical evidence for TICH treatment with deferoxamine mesylate. Patients with isolated TICH, confirmed by head computed tomography, were enrolled prospectively from January 2013 to December 2016. Patients were divided non-randomly into an experimental or control group as decided by the attending neurosurgeon. Patients in the experimental group received intravenous deferoxamine mesylate (20 mg/kg daily) from the day of admission for 5 consecutive days. We evaluated the impact of deferoxamine mesylate on the change in edema volume and the absorption of hematoma volume using a propensity score-matched analysis. In total, 190 patients were included. After matching, 94 patients were included in the final analysis (47 per group); no variable differed significantly between the two groups. The hematoma volume on the 7th day in the control group was higher than that at the same time-point in the experimental group (9.4 ± 7.2 vs. 5.2 ± 4.8 mL; p = 0.001). There was no difference in hematoma volume on Day 1 (12.6 ± 7.8 vs. 12.8 ± 6.4 mL; p = 0.896), Day 3 (12.4 ± 7.4 vs. 11.4 ± 4.9 mL; p = 0.442), and Day 14 (3.2 ± 3.0 vs. 2.5 ± 2.6 mL; p = 0.215) between the groups. The absorption of hematoma volume between the 1st and 3rd days and the 1st and 7th days in the experimental group was higher than that during the same periods in the control group. The edema volumes on the 3rd, 7th, and 14th days in the control group were higher than those at the same time-points in the experimental group. There was no difference in edema volume on the 1st day. The changes in edema volume between the 1st and 3rd days, the 1st and 7th days, and the 1st and 14th days in the control group were higher than those during the same periods in the experimental group. Deferoxamine mesylate may accelerate hematoma absorption and inhibit edema after TICH; however, further investigation is required to reach definitive conclusions.
甲磺酸去铁胺可以穿透血脑屏障，减少神经组织中的铁积累；此外，它除了与铁离子结合之外，还有多种神经保护功能。这种铁螯合剂有望成为治疗脑出血的新方法。本研究评估了甲磺酸去铁胺对创伤性脑出血（TICH）后血肿和水肿吸收的影响，为 TICH 采用甲磺酸去铁胺治疗提供了临床证据。前瞻性纳入 2013 年 1 月至 2016 年 12 月经头部 CT 证实的单纯 TICH 患者。根据主管神经外科医生的决定，将患者非随机分为实验组和对照组。实验组患者入院后每日静脉滴注甲磺酸去铁胺（20mg/kg），连用 5 天。采用倾向评分匹配分析评估甲磺酸去铁胺对水肿体积变化和血肿体积吸收的影响。共纳入 190 例患者。匹配后，94 例患者纳入最终分析（每组 47 例）；两组间无显著差异。对照组第 7 天血肿体积高于实验组同期（9.4±7.2 vs. 5.2±4.8ml；p=0.001）。第 1 天（12.6±7.8 vs. 12.8±6.4ml；p=0.896）、第 3 天（12.4±7.4 vs. 11.4±4.9ml；p=0.442）和第 14 天（3.2±3.0 vs. 2.5±2.6ml；p=0.215）两组间血肿体积无差异。实验组第 1 天至第 3 天及第 1 天至第 7 天血肿体积吸收量高于对照组同期。对照组第 3、7、14 天水肿体积高于实验组同期。第 1 天水肿体积无差异。对照组第 1 天至第 3 天、第 1 天至第 7 天及第 1 天至第 14 天的水肿体积变化大于实验组同期。甲磺酸去铁胺可能加速 TICH 后的血肿吸收和抑制水肿；但需要进一步研究才能得出明确结论。
