重组人促红细胞生长素治疗老年急性大脑中动脉缺血性脑卒中的研究

目的研究重组人促红细胞生长素(recombinant human erythropoietin,rhEPO)治疗老年急性缺血性脑卒中患者的有效性及安全性。方法入选74例年龄≥75岁的老年急性缺血性脑卒中患者,经磁共振弥散加权成像检查证实在大脑中动脉的范围内,将患者随机分为治疗组36例和对照组38例,患者入院后前3 d每日分别给予rhEPO或生理盐水静脉注射治疗。观察第1、3、7、20和30天美国国立卫生研究院卒中量表(NIHSS)评分和脑梗死体积变化,ELISA法检测损伤标记物S100B水平。结果与对照组比较,治疗组第20、30天NIHSS评分明显下降(P<0.05);第20天脑梗死体积明显降低(46.5±32.3)cm~3 vs(89.6±68.9)cm~3,P<0.01];第3、7和20天血清S100B水平明显下降(1.45±0.25)μg/L vs(1.58±0.13)μg/L,(1.41±0.20)μg/L vs(1.69±0.15)μg/L,(0.38±0.14)μg/L vs(0.78±0.26)μg/L,P<0.01]。结论老年急性缺血性脑卒中患者对静脉注射高剂量rhEPO治疗耐受性良好,并且可改善患者30 d后的临床预后。

Recombinant human erythropoietin in treatment of elderly patients with middle cerebral artery acute ischemic stroke

Objective To study the safety and efficacy of recombinant human erythropoietin (rhEPO) in treatment of advance-aged patients with acute ischemic stroke.Methods Seventyfour acute ischemic stroke patients at the age≥75 years,with their diagnosis established by diffusion -weighted MRI,were randomly divided into treatment group(n = 36) and control group(n = 38).The patients received rhEPO20 000 U/(50 ml·30 min)]or intravenous saline once a day in the first 3 days after admission.Scores of acute ischemic stroke on the NIHSS and cerebral infarction size were recorded,and levels of damage marker,S100B,waere measured by ELISA on days 1,3,7,20 and 30.Results The scores of acute ischemic stroke on the NIHSS were significantly lower in treatment group than in control group on days 20 and 30 after rhEPO treatment(P< 0.05).The cerebral infarction size was significantly smaller in treatment group than in control group on day 20 after rhEPO treatment(P<0.01).The serum S100B level was significantly lower in treatment group than in control group on days 3,7 and 20 after rhEPO treatmentd.45±0.25μg/L vs 1.58±0.13μg/L,1.41±0.20μg/L vs 1.69±0.15μg/L,0.38±0.14μg/L vs 0.78±0.26μg/L,P<0.01).Conclusion Intravenous high dose rhEPO is well tolerated in elderly acute ischemic stroke patients and can improve their clinical outcome.