Department of Emergency Medicine, The First People's Hospital of Linhai, Taizhou, Zhejiang, China.
Eur Rev Med Pharmacol Sci. 2023 Jul;27(13):6101-6110. doi: 10.26355/eurrev_202307_32966.
Acute spinal cord injury (SCI) is a devastating disease that causes immense physical and mental harm to the patient and the family, and society and requires a multidisciplinary approach to treatment. The study of acute SCI has a long history but is still emerging. As the mechanism and pathophysiology of acute SCI are continuously being studied and explored, the treatment of SCI has developed significantly. Steroids are thought to provide neuroprotection in patients with acute SCI by improving perfusion, reducing edema, modulating inflammatory cells, and inhibiting lipid peroxidation, leading to their widespread application in clinical medicine. The use of steroids for SCI is controversial because of limited clinical evidence. With the accumulation of evidence on the effectiveness of steroid treatment in improving neurological function and the evidence of severe side effects, a gradual change in the treatment of SCI with steroids has become inevitable. Most scholars have focused on the routine use of steroids because of the indefinite improvement in neurological function and the occurrence of severe adverse events. Therefore, this review aims to provide an overview of the mechanism, progress, and related controversies to comprehensively understand the value and future direction of steroid application in acute SCI.
急性脊髓损伤（SCI）是一种毁灭性疾病，会给患者及其家庭以及社会带来巨大的身心伤害，需要多学科的治疗方法。急性 SCI 的研究历史悠久，但仍在不断发展。随着对急性 SCI 的机制和病理生理学的不断研究和探索，SCI 的治疗有了显著的发展。类固醇被认为通过改善灌注、减少水肿、调节炎症细胞和抑制脂质过氧化来提供急性 SCI 患者的神经保护作用，因此在临床医学中广泛应用。类固醇在 SCI 中的应用存在争议，因为临床证据有限。随着类固醇治疗在改善神经功能方面的有效性证据的积累，以及严重副作用的证据，类固醇治疗 SCI 的方式逐渐发生变化是不可避免的。由于神经功能改善不明确和严重不良事件的发生，大多数学者都关注类固醇的常规使用。因此，本综述旨在概述其作用机制、进展和相关争议，以全面了解类固醇在急性 SCI 中的应用价值和未来方向。
