氯唑生坦附加治疗对动脉瘤性蛛网膜下腔出血后迟发性脑微循环障碍的有益影响

IF 1.3 Q4 CLINICAL NEUROLOGY
Hidenori Suzuki , Hideki Nakajima , Tomonori Ichikawa , Ryuta Yasuda , Takeshi Okada , Fuki Goto , Shota Ito , Yasutaka Horiuchi , Yotaro Kitano , Hirofumi Nishikawa , Masashi Fujimoto , Naoki Toma
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引用次数: 0

摘要

目的这项回顾性研究旨在分析前瞻性收集的计算机断层扫描(CT)灌注成像数据,并探讨加用克拉生坦是否能预防蛛网膜下腔出血(SAH)后延迟性脑微循环功能障碍。方法共有 36 名因前循环动脉瘤破裂导致的非轻度 SAH 且无明显心肺功能障碍的连续患者(平均年龄 67.9 岁;入院时世界神经外科医师联合会分级 IV-V 级,66.7%)接受了SAH后第3天的动脉瘤阻塞治疗,随后接受了我们的常规治疗(盐酸法舒地尔、西洛他唑和培南帕尼给药;n = 20;2020年1月至2022年5月)或在常规治疗基础上加用克拉索坦(10 mg/hr)(n = 16;2022年6月至2023年5月)。结果 氯唑生坦附加治疗对围术期液体管理有明显影响,但似乎对SAH后6.5至7.0天的CT灌注成像结果没有影响。结论:研究结果表明,氯唑生坦附加治疗对SAH术后血管痉挛相关的延迟性脑微循环功能障碍有益,可能是通过改善阻力较小的动脉或小动脉的血流量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Beneficial effects of clazosentan add-on treatment on delayed cerebral microcirculatory disturbances after aneurysmal subarachnoid hemorrhage

Objective

This retrospective study aimed to analyze the prospectively collected data of computed tomography (CT) perfusion imaging and to examine if clazosentan add-on administration prevented post-subarachnoid hemorrhage (SAH) delayed cerebral microcirculatory dysfunctions.

Methods

A total of 36 consecutive patients with non-mild SAH due to ruptured anterior circulation aneurysms and no significant cardiopulmonary dysfunctions (mean age, 67.9 years; and admission World Federation of Neurological Surgeons grades IV–V, 66.7 %) underwent aneurysmal obliteration up to day 3 post-SAH, followed by our conventional treatment (fasudil hydrochloride, cilostazol and perampanel administrations; n = 20; January 2020 to May 2022) or add-on administration of clazosentan (10 mg/hr) to the conventional treatment (n = 16; June 2022 to May 2023).

Results

Clazosentan add-on treatment significantly affected perioperative fluid management, which appeared to have no effects on the finding of CT perfusion imaging performed a median of 6.5 to 7.0 days post-SAH. However, cerebral blood flow and mean transit time were better in patients receiving add-on administration of clazosentan, although angiographic vasospasm frequencies and cerebral blood volume values were similar between the two treatment groups.

Conclusion

The findings suggest that clazosentan add-on treatment has beneficial effects against post-SAH angiographic vasospasm-unrelated delayed cerebral microcirculatory dysfunctions possibly by improving blood flow in smaller resistance arteries or arterioles.

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来源期刊
Brain Hemorrhages
Brain Hemorrhages Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
52
审稿时长
22 days
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