Shirani Mohammad, Sohrabiasl Masoud, Meshkini Ali, Mirzaei Farhad, Hashemi Seyed Mohammad Mehdi, Jafari Fatemeh, Salami Ali, Rafiei Ebrahim, Iranmehr Arad
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran.
Korean J Neurotrauma. 2025 Apr 14;21(2):124-136. doi: 10.13004/kjnt.2025.21.e9. eCollection 2025 Apr.
Spontaneous intracranial hemorrhage (ICH) is a catastrophic medical condition associated with significant morbidity and mortality. Because the accumulation of unbound iron following ICH contributes to secondary brain injury, deferoxamine, an approved chelation drug, has become the center of attention. However, its therapeutic effects remain a matter of dispute. This double-blind randomized controlled trial aimed to investigate the therapeutic potential of deferoxamine in terms of neurological and radiological outcomes.
The study enrolled 42 participants diagnosed with spontaneous ICH, confirmed by computed tomography, and randomly assigned them to either a deferoxamine treatment group or the placebo control group. The placebo control group received routine treatment plus a placebo, whereas the treatment group received routine treatment conjugated with 7.5 mg/kg of deferoxamine per hour intravenously over the first 3 days. The study compared the hematoma and edema volumes, Glasgow coma scale (GCS) scores, and mortality rates between the 2 groups. Our study employed rigorous randomization and blinding procedures to ensure unbiased results.
There was a significant (<0.05) improvement in the patients' GCS scores until the fourth day; however, no significant difference was noted thereafter. In addition, both the edema and hematoma volumes were significantly lower in the deferoxamine treatment group versus the placebo control group, as were the length of stay, intubation requirement, and mortality.
Deferoxamine administration can, at least within a short timeframe, improve neurological and radiological parameters.
自发性颅内出血（ICH）是一种灾难性的医学病症，伴有显著的发病率和死亡率。由于ICH后游离铁的积累会导致继发性脑损伤，去铁胺作为一种已获批准的螯合药物，已成为关注焦点。然而，其治疗效果仍存在争议。这项双盲随机对照试验旨在研究去铁胺在神经和影像学结果方面的治疗潜力。
该研究纳入了42名经计算机断层扫描确诊为自发性ICH的参与者，并将他们随机分为去铁胺治疗组或安慰剂对照组。安慰剂对照组接受常规治疗加安慰剂，而治疗组在前3天接受常规治疗并每小时静脉注射7.5mg/kg去铁胺。该研究比较了两组之间的血肿和水肿体积、格拉斯哥昏迷量表（GCS）评分及死亡率。我们的研究采用了严格的随机化和盲法程序以确保结果无偏倚。
直到第四天患者的GCS评分有显著（<0.05）改善；然而，此后未观察到显著差异。此外，去铁胺治疗组的水肿和血肿体积均显著低于安慰剂对照组，住院时间、插管需求及死亡率也是如此。
至少在短时间内，给予去铁胺可改善神经和影像学参数。
