重组人促红细胞生长素治疗老年急性缺血性中风患者
2012-05-09 11:35:22   来源： 丁香园   作者：  评论：0 点击：

重组人促红细胞生长素治疗老年急性缺血性中风患者
张勇黄洪波杜万红刘小阳陈宏贾巧  邢红专杨婧刘超 胡罗建

 
摘要：背景与目的许多前期与先导临床试验都证明重组人促红细胞生长素(recombinant human erythropoietin -rHuEPO)具有神经保护作用，治疗缺血性中风的患者有效。本试验目的是检测rHuEPO用于治疗老年急性缺血性脑中风患者有效性及安全性。方法本试验共纳入74例年龄在75岁以上的老年急性缺血性中风的患者，起病在24小时以内，缺血性中风经核磁共振弥散加权显像（diffusion-weighted MRI-DWI）证实在大脑中动脉的范围内，前3天每天分别接受rHuEPO (20000 IU/50 ml/30 min)或生理盐水静脉注射处理。观察终点为30天NIHSS(美国国立健康研究所中风评分)变化，梗塞大小变化（以系列DWI检查评价）及损伤标志物S100B。结果与对照组相比，rHuEPO治疗与NIHSS和S100B的改善相关。同时发现rHuEPO治疗明显减少了由DWI测得的损伤大小。安全性无担心。结论 静脉注射高剂量rHuEPO治疗老年急性缺乏缺血性中风患者耐受性良好并且改善了1个月后的临床愈后。
关键字：促红细胞生长素  中风  神经保护  NIHSS  DWI  S100B[1]
 
Recombinant Human Erythropoietin in the Treatment of Acute Ischemic Stroke in the elderly Patients
Zhang-yong Huang-hongbo Du-wanhong Liu-xiaoyang Chen-hong Jia-qiao Xing-hongzhuan  Yang-jing  Liu-chao  Hu-luojian
（Department of Geratology, 163 Hospital of PLA, Changsha, Hunan 410003, China）
Abstract: Background and ObjectiveNumerous preclinical findings and a clinical pilot study suggest that recombinant human erythropoietin (EPO) provides neuroprotection that may be beneficial for the treatment of patients with ischemic stroke. The objective of this trial is to study the safety and efficacy of rHuEPOfor treatment of acute ischemic stroke in the advanced patients.MethodsThis clinical trial enrolled 74 patients(age≥75) with acute ischemic stroke. Within 48 hours of symptom onset, ischemic stroke within the middle cerebral artery territory confirmed by diffusion-weighted MRI, patients received either rHuEPO (20000 IU/50 ml/30 min)or saline intravenously once daily for the first 3 days after stroke. The study endpoints were NIH stroke scales at day 30, evolution of infarct size (sequential MRI evaluation using diffusion-weighted [DWI] and the damage marker S100B.ResultsCompared to controls, rHuEPO treatment was associated with an improvement in NIHSS and S100B. A strong trend for reduction in infarct size in rhEPO patients as compared to controls was observed by DWI. No safety concerns were identified.ConclusionIntravenous high-dose rHuEPOis well tolerated in acute ischemic stroke  in the the elderly Patients and associated with an improvement in clinical outcome at 1 month.
Key words:  Erythropoietin   Stroke  Neuroprotection   NIHSS  DWI  S100B