Effects of the free radical scavenger, edaravone, on the development of postoperative cognitive impairment in patients undergoing carotid endarterectomy
Effects of the free radical scavenger, edaravone, on the development of postoperative cognitive impairment in patients undergoing carotid endarterectomy
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DOI：
10.1016/j.surneu.2005.01.008
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发表时间：
2005-10-01
影响因子：
--
通讯作者：
Ogawa, A
中科院分区：
文献类型：
--
作者：
Ogasawara, K;Yamadate, K;Ogawa, A
背景：一些接受颈动脉内膜切除术（CEA）的患者会出现术后认知障碍。本病例队列研究的目的是确定一种新型自由基清除剂依达拉奉是否可以预防CEA后认知功能障碍的发生。方法：55例同侧颈内动脉（ICA）狭窄患者（>= 70%）行CEA +依达拉奉夹持术。术前和术后第一个月分别进行神经心理测试。在CEA前后和术后第三天使用单光子发射计算机断层扫描测量脑血流量。结果：仅1例（2%）患者出现术后脑高灌注（脑血流量较术前增加>= 100%）的认知功能障碍。对照组（92例CEA患者未给予依达拉奉）术后认知功能障碍发生率显著高于对照组（12%）（P = 0.0298，对照组与治疗组）。Logistic回归分析显示，术后脑高灌注和未使用依达拉奉预处理是术后认知功能障碍的重要独立预测因素。结论：依达拉奉预处理可预防CEA后认知功能障碍的发生。(c) 2005爱思唯尔公司版权所有。
Background: Some patients undergoing carotid endarterectomy (CEA) experience postoperative cognitive impairment. The purpose of the present case cohort study with historical control was to determine whether pretreatment with a novel free radical scavenger, edaravone, could prevent development of cognitive impairment after CEA.Methods: Fifty-five patients with ipsilateral internal carotid artery (ICA) stenosis (>= 70%) underwent CEA with administration of edaravone before ICA clamping. Neuropsychological testing was performed preoperatively and at the first postoperative month. Cerebral blood flow was also measured using single-photon emission computed tomography before and immediately after CEA and on the third postoperative day.Results: Postoperative cognitive impairment was observed in only 1 (2%) patient, who exhibited postoperative cerebral hyperperfusion (cerebral blood flow increase >= 100% compared with preoperative values). Incidence of postoperative cognitive impairment in the control group (92 CEA patients without administration of edaravone) was significantly higher (12%) (P = .0298, control vs treatment group). Logistic regression analysis demonstrated that postoperative cerebral hyperperfusion and absence of pretreatment with edaravone were significant independent predictors of postoperative cognitive impairment.Conclusion: Pretreatment with edaravone can prevent development of cognitive impairment after CEA. (c) 2005 Elsevier Inc. All rights reserved.