Park C O
Department of Neurosurgery, Inha Hospital, College of Medicine, Inha University, Sung Nam City, Korea.
Yonsei Med J. 1998 Oct;39(5):395-403. doi: 10.3349/ymj.1998.39.5.395.
Our study was designed to determine whether methylprednisolone exerts a beneficial effect after experimental moderate diffuse brain injury and whether this possible beneficial effect is affected by the dosage, the timing of administration, and the methods of treatment. A total of 200 anesthetized adult rats were injured utilizing a weight-drop device through a Plexiglas guide tube. These rats were divided into eight groups: Group 1 (n = 35) was assigned to receive no methylprednisolone after impact (control group), Group 2 (n = 25) received an initial intraperitoneal administration of methylprednisolone with a dose of 5 mg/kg at 1 hour after cranial impact, followed by administration with a maintenance dose of 5 mg/kg/4 hours. Group 3 (n = 25), group 5 (n = 25), and group 7 (n = 20) received an initial 30 mg/kg at 1 hour, 4 hours, and 8 hours, respectively without a maintenance dose. Group 4 (n = 25), group 6 (n = 25), and group 8 (n = 20) received an initial 30 mg/kg at 1 hour, 4 hours, and 8 hours after impact, with a maintenance dose of 15 mg/kg/4 hours. Measured water content of brain tissue expressed the amount of water as the difference between fresh and dry weight. At 48 hours after impact, the water content in group 4 and 6 were significantly lower than group 1. Mean +/- SD was 61.4 +/- 0.37% in group 4 (p < 0.03), 61.5 +/- 0.34% in group 6 (p < 0.001), and 63.6 +/- 0.48% in group 1. Compared to group 1, the difference was not statistically significant in group 2 (p > 0.1), group 3 (p > 0.5), group 5 (p > 0.6), group 7 (p > 0.1), and group 8 (p > 0.5). Groups treated with mega dose before 4 hours after head injury, including maintenance dose, showed beneficial effects. Our study suggests that the efficacy of methylprednisolone in head injury was related to the dosage, the timing of administration, and method of treatment.
我们的研究旨在确定甲基强的松龙在实验性中度弥漫性脑损伤后是否发挥有益作用，以及这种可能的有益作用是否受到剂量、给药时间和治疗方法的影响。总共200只麻醉成年大鼠通过有机玻璃导管利用重物下落装置致伤。这些大鼠被分为八组：第1组（n = 35）在撞击后不接受甲基强的松龙（对照组），第2组（n = 25）在颅脑撞击后1小时腹腔内首次给予5 mg/kg的甲基强的松龙，随后以5 mg/kg/4小时的维持剂量给药。第3组（n = 25）、第5组（n = 25）和第7组（n = 20）分别在1小时、4小时和8小时首次给予30 mg/kg，无维持剂量。第4组（n = 25）、第6组（n = 25）和第8组（n = 20）在撞击后1小时、4小时和8小时首次给予30 mg/kg，并以15 mg/kg/4小时的维持剂量给药。测量的脑组织含水量以新鲜重量与干重之差表示水分含量。撞击后48小时，第4组和第6组的含水量显著低于第1组。第4组的平均值±标准差为61.4±0.37%（p < 0.03），第6组为61.5±0.34%（p < 0.001），第1组为63.6±0.48%。与第1组相比，第2组（p > 0.1）、第3组（p > 0.5）、第5组（p > 0.6）、第7组（p > 0.1）和第8组（p > 0.5）的差异无统计学意义。在头部受伤后4小时内给予大剂量（包括维持剂量）治疗的组显示出有益效果。我们的研究表明，甲基强的松龙在头部损伤中的疗效与剂量、给药时间和治疗方法有关。
