氢化泼尼松对蛛网膜下腔出血患者脑灌注的影响

目的探讨大剂量氢化泼尼松对蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)患者脑灌注的影响。方法将19例CT分级在Ⅲ级以下的SAH患者随机分成2组:①治疗组,大剂量氢化泼尼松(1.0mg/kg)冲击治疗。②对照组,单纯应用一般治疗。氢化泼尼松冲击治疗3天后,行脑CT灌注成像扫描,监测颞叶及额叶脑血管灌注情况,结合临床症状判断脑血管痉挛的程度。结果9例应用大剂量氢化泼尼松加上一般治疗的患者,与单纯一般治疗组相比,临床症状及额叶、颞叶的脑血流情况均得到明显改善。脑血容量(CBV),脑血流量(CBF),平均通过时间(MTT),较对照组有明显提高(P(0.05)。结论大剂量氢化泼尼松冲击治疗能够提高蛛网膜下腔出血患者的脑灌注,从而减轻脑血管痉挛,改善脑供血。

Clinical study on the treatment of cerebral vasospasm after subarachnoid hemorrhage with high dose hydroprednisone

Objective To explore the pharmacological method in order to improve clinical manifestation of the patient who has subarachnoid hemorrhage. Methods The cases of SAH with less than the 3rd grade in CT Fishers Classification were divided into two group（9 cases of treated ＇group with high dose Prednisolone （1.0mg/kg） , 10 cases would be treated routinely ）. All cases were checked by CT perfustion to observe angiographic of vasospasmafter three days. Results The Prednisolone significantly reduced angiographic severity of cerebral vasospasm. In the treated group, the blood stream of brain were enhanced compared with non-treated group. Conclusion The result suggests that high dose Prednisolone could increase cerebral vasospasm of patient suffering from SAH through controlling inflammation.