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【drug-news】甲泼尼龙对脊髓损伤严重性的影响
Leypold BG, Flanders AE, Schwartz ED, Burns AS.
Spine. 2007 Feb 1;32(3):373-8; discussion 379-81
http://www.ncbi.nlm.nih.gov/sites/entrez
STUDY DESIGN: Retrospective study comparing spinal cord injury (SCI) lesion characteristics in methylprednisolone (MPS) treated versus untreated patients as demonstrated by magnetic resonance (MR) imaging.
OBJECTIVE: Determine if the administration of MPS immediately following SCI affects lesion severity.
SUMMARY OF BACKGROUND DATA: The administration of MPS in the setting of acute SCI has become controversial. Since magnetic resonance imaging (MRI) is sensitive for the detection of spinal cord edema and hemorrhage, changes in lesion characteristics would support a biologic effect due to MPS.
METHODS: Patients with cervical spinal injury treated with the recommended dose of methylprednisolone (bolus 30 mg/kg + 5.4 mg/kg per hour over 24 hours) initiated within 8 hours of injury were compared to historical controls that did not receive steroids. All patients (n = 82) sustained clinically complete SCI (ASIA Grade A) and underwent MRI on the same 1.5 Tesla unit. The length of spinal cord edema, presence/absence of intramedullary hemorrhage, and length of intramedullary hemorrhage were measured on T2-weighted and gradient echo MR images. Comparisons of lesion severity were then made between untreated and treated subjects.
RESULTS: Forty-eight of 82 patients with complete injuries received MPS therapy. After accounting for differences in the mean age of the treatment and control groups, multiple regression analysis demonstrated a persistent reduction in the mean length of intramedullary hemorrhage, 2.6 U in the treatment group versus 4.4 U in the control group (P = 0.04). Although there was a reduction in the number of patients exhibiting spinal cord hemorrhage in the treated group compared with the untreated group (65% vs. 91%), this result was not statistically significant (P = 0.16). There was no statistically significant effect of MPS treatment on the mean length of the spinal cord edema between treated versus untreated subjects (10.3 vs. 12.0, respectively, P = 0.85).
CONCLUSIONS: MRI suggests MPS therapy in the acute phase of spinal cord injury may decrease the extent of intramedullary spinal cord hemorrhage.
本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 The Impact of Methylprednisolone on Lesion Severity Following Spinal Cord Injury.
甲泼尼龙对脊髓损伤严重性的影响
Abstract:
摘要
Study Design. Retrospective study comparing spinal cord injury (SCI) lesion characteristics in methylprednisolone (MPS) treated versus untreated patients as demonstrated by magnetic resonance (MR) imaging.
研究设计：回顾性研究脊髓损伤（SCI）中甲泼尼龙(MPS)治疗和未治疗者的损害特征对比，二者经MRI证实均为脊髓损伤。
Objective. Determine if the administration of MPS immediately following SCI affects lesion severity.
目的：测定SCI后立即给药甲泼尼龙是否影响损害严重性。
Summary of Background Data. The administration of MPS in the setting of acute SCI has become controversial. Since magnetic resonance imaging (MRI) is sensitive for the detection of spinal cord edema and hemorrhage, changes in lesion characteristics would support a biologic effect due to MPS.
背景数据概要：对急性SCI患者的治疗是否给予甲泼尼龙是有争议的。由于MRI对脊髓水肿和出血敏感，MRI上损伤征象的改变会使甲泼尼龙对脊髓损伤产生生物学影响。
Methods. Patients with cervical spinal injury treated with the recommended dose of methylprednisolone (bolus 30 mg/kg + 5.4 mg/kg per hour over 24 hours) initiated within 8 hours of injury were compared to historical controls that did not receive steroids. All patients (n = 82) sustained clinically complete SCI (ASIA Grade A) and underwent MRI on the same 1.5 Tesla unit. The length of spinal cord edema, presence/absence of intramedullary hemorrhage, and length of intramedullary hemorrhage were measured on T2-weighted and gradient echo MR images. Comparisons of lesion severity were then made between untreated and treated subjects.
方法：对脊髓损伤8小时内的颈髓损伤患者给予推荐剂量MPS治疗，未接受激素治疗者进行对照。82例患者均为临床完全性脊髓损伤，并经1.5T当量的 MRI检查。在T2加权相和梯度回波相上测量脊髓水肿的长度，是否有髓内出血以及髓内出血的长度，并对治疗组和非治疗组的损害严重性进行对比。
Results. Forty-eight of 82 patients with complete injuries received MPS therapy. After accounting for differences in the mean age of the treatment and control groups, multiple regression analysis demonstrated a persistent reduction in the mean length of intramedullary hemorrhage, 2.6 U in the treatment group versus 4.4 U in the control group (P = 0.04). Although there was a reduction in the number of patients exhibiting spinal cord hemorrhage in the treated group compared with the untreated group (65% vs. 91%), this result was not statistically significant (P = 0.16). There was no statistically significant effect of MPS treatment on the mean length of the spinal cord edema between treated versus untreated subjects (10.3 vs. 12.0, respectively, P = 0.85).
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作者:admin@医学,生命科学 2010-09-27 17:11
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