Sabouri Masih, Momeni Mahmood, Khorvash Fariborz, Rezvani Majid, Tabesh Homayon
Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2017 Jul 14;6:83. doi: 10.4103/2277-9175.210660. eCollection 2017.
Cerebral vasospasm is a prolonged, occasionally severe, but reversible narrowing of the cerebral arteries that begins 3 to 5 days after the hemorrhage becomes maximal at 14 days. This study is designed to evaluate the effect of dantrolene on the reduction of vasospasm following aneurysmal subarachnoid hemorrhage (SAH).
This randomized controlled clinical trial was conducted on 32 patients with proven aneurysms in AL-Zahra hospital during 2011-2013. They were randomly divided into two groups. In all patients, daily transcranial Doppler sonography was performed and as soon as the diagnosis of vasospasm onset in the first group, in addition to conventional treatment of vasospasm 2.5 mg/kg Dantrolene infusion within 60 minutes and while the blood pressure and heart rate of patient monitored, and arterial flow velocity changes such as PSV and MFV were measured by transcranial Doppler sonography in 45, 90 and 135 minutes. Data was analyzed by SPSS 22 and Chi-square, Student , Mann-Whitney and ANOVA tests with repeated observations.
There was no significant difference in the site of the aneurysm in the two groups. The mean of PSV index prior to treatment and the 45 minute was not different but at 90 and 135 minutes it was significantly lower in the Dantrolene receiving group ( < 0.05). The mean of MFV index prior to intervention and in the 45 minute was not different between two groups, but at 90 and 135 minutes was significantly lower in the target group.
Using dantrolene in patients with artery vasospasm significantly reduced artery spasm and increased the patient recovery.
脑血管痉挛是一种脑动脉的持续性、偶尔严重但可逆的狭窄，在出血后3至5天开始，在14天时达到最大程度。本研究旨在评估丹曲林对动脉瘤性蛛网膜下腔出血（SAH）后血管痉挛减轻的效果。
本随机对照临床试验于2011年至2013年在阿尔-扎赫拉医院对32例确诊为动脉瘤的患者进行。他们被随机分为两组。对所有患者每日进行经颅多普勒超声检查，一旦第一组诊断为血管痉挛发作，除了常规的血管痉挛治疗外，在60分钟内输注2.5mg/kg丹曲林，同时监测患者的血压和心率，并在45、90和135分钟时通过经颅多普勒超声测量诸如PSV和MFV等动脉血流速度变化。数据采用SPSS 22进行分析，并进行卡方检验、学生检验、曼-惠特尼检验和重复观测的方差分析。
两组动脉瘤的部位无显著差异。治疗前和45分钟时PSV指数的平均值无差异，但在90和135分钟时，接受丹曲林治疗的组显著更低（P<0.05）。干预前和45分钟时两组MFV指数的平均值无差异，但在90和135分钟时，目标组显著更低。
在动脉血管痉挛患者中使用丹曲林可显著减轻动脉痉挛并提高患者恢复率。
