Effects of Deferoxamine Mesylate on Hematoma and Perihematoma Edema after Traumatic Intracerebral Hemorrhage
Effects of Deferoxamine Mesylate on Hematoma and Perihematoma Edema after Traumatic Intracerebral Hemorrhage
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甲磺酸去铁胺对外伤性脑出血后血肿及血肿周围水肿的影响
DOI：
10.1089/neu.2017.5033
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发表时间：
2017-10-01
影响因子：
4.2
通讯作者：
Hu, Jin
中科院分区：
文献类型：
--
作者：
Yu, Jian;Yuan, Qiang;Hu, Jin
甲磺酸去铁胺可穿过血脑屏障，减少神经组织中铁的积累；此外，除了与铁离子络合外，它还具有多种神经保护功能。此类铁螯合剂有望成为脑出血的新治疗选择。本研究评价甲磺酸去铁胺对创伤性脑出血（TICH）后血肿和水肿吸收的影响，为甲磺酸去铁胺治疗TICH提供临床证据。 2013 年 1 月至 2016 年 12 月前瞻性入组经头部计算机断层扫描证实的孤立性 TICH 患者。根据主治神经外科医生的决定，患者被非随机分为实验组或对照组。实验组患者自入院之日起静脉注射甲磺酸去铁胺（20mg/kg/d），连续5天。我们使用倾向评分匹配分析评估了甲磺酸去铁胺对水肿体积变化和血肿体积吸收的影响。总共包括 190 名患者。匹配后，最终纳入94例患者（每组47例）；两组之间没有显着差异的变量。对照组第7天的血肿量高于实验组同一时间点的血肿量（9.4±7.2 vs. 5.2±4.8mL；p = 0.001）。第 1 天（12.6 +/- 7.8 对比 12.8 +/- 6.4mL；p = 0.896）、第 3 天（12.4 +/- 7.4 对比 11.4 +/- 4.9mL；p = 0.442）和第 14 天（3.2 +/- 3.0 对比 2.5 +/- 2.6mL；p = 0.442）血肿体积没有差异。 p = 0.215) 组之间。实验组第1~3天、第1~7天血肿量吸收量高于对照组同期。对照组第3、7、14天的水肿体积高于实验组同一时间点的水肿体积。第一天水肿量没有差异。对照组第1～3天、第1～7天、第1～14天水肿体积变化均高于实验组同期。甲磺酸去铁胺可加速TICH后血肿吸收并抑制水肿；然而，还需要进一步调查才能得出明确的结论。
Deferoxamine mesylate can cross the blood-brain barrier and reduce iron accumulation in nervous tissue; moreover, it has a variety of neuroprotective functions in addition to complexing with iron ions. Such iron chelators are expected to become a new treatment option for intracerebral hemorrhage. This study evaluated the effects of deferoxamine mesylate on hematoma and edema absorption after traumatic intracerebral hemorrhage (TICH), and it provides clinical evidence for TICH treatment with deferoxamine mesylate. Patients with isolated TICH, confirmed by head computed tomography, were enrolled prospectively from January 2013 to December 2016. Patients were divided non-randomly into an experimental or control group as decided by the attending neurosurgeon. Patients in the experimental group received intravenous deferoxamine mesylate (20 mg/kg daily) from the day of admission for 5 consecutive days. We evaluated the impact of deferoxamine mesylate on the change in edema volume and the absorption of hematoma volume using a propensity score-matched analysis. In total, 190 patients were included. After matching, 94 patients were included in the final analysis (47 per group); no variable differed significantly between the two groups. The hematoma volume on the 7th day in the control group was higher than that at the same time-point in the experimental group (9.4 +/- 7.2 vs. 5.2 +/- 4.8mL; p = 0.001). There was no difference in hematoma volume on Day 1 (12.6 +/- 7.8 vs. 12.8 +/- 6.4mL; p = 0.896), Day 3 (12.4 +/- 7.4 vs. 11.4 +/- 4.9mL; p = 0.442), and Day 14 (3.2 +/- 3.0 vs. 2.5 +/- 2.6mL; p = 0.215) between the groups. The absorption of hematoma volume between the 1st and 3rd days and the 1st and 7th days in the experimental group was higher than that during the same periods in the control group. The edema volumes on the 3rd, 7th, and 14th days in the control group were higher than those at the same time-points in the experimental group. There was no difference in edema volume on the 1st day. The changes in edema volume between the 1st and 3rd days, the 1st and 7th days, and the 1st and 14th days in the control group were higher than those during the same periods in the experimental group. Deferoxamine mesylate may accelerate hematoma absorption and inhibit edema after TICH; however, further investigation is required to reach definitive conclusions.