Abstract：
Magnesium sulfate (MgSO4) is a potential neuroprotective agent for patients with aneurysmal subarachnoid hemorrhage (SAH). We analyzed the effect of early application of intraoperative intravenous MgSO4 and compared cerebral vasospasm (CV), delayed cerebral ischemia (DCI), and neurological outcome in 2 patient cohorts.
A retrospective matched-pair analysis from patients at a single center in Germany was performed without (group A) and with (group B) MgSO4 application <24 hours after diagnosis. Pairs were matched according to the known risk factors for DCI and CV (age, Fisher grade, smoking, severity of SAH). Incidence of CV and DCI and neurological outcome using the modified Rankin Scale score 3 and 12 months after SAH were recorded.
The inclusion criteria were met by 196 patients. After risk stratification, 48 patients were included in the final analysis (age 54.2 ± 8.1 years; 30 women and 18 men) and were assigned to group A (n = 24) or group B (n = 24). CV occurred less frequently in group B (33%) than in group A (46%). Likewise, DCI was present in 13% in group B compared with 42% in group A. After 12 months, 22 patients in group B had a favorable functional outcome (modified Rankin Scale score 0-3) compared with 15 patients in group A.
In this study, the incidence of CV and DCI was lower in patients receiving intravenous MgSO4 within 24 hours after aneurysmal SAH onset. Favorable functional outcome was more likely in the MgSO4 group after 12 months of follow-up.
A retrospective matched-pair analysis from patients at a single center in Germany was performed without (group A) and with (group B) MgSO4 application <24 hours after diagnosis. Pairs were matched according to the known risk factors for DCI and CV (age, Fisher grade, smoking, severity of SAH). Incidence of CV and DCI and neurological outcome using the modified Rankin Scale score 3 and 12 months after SAH were recorded.
The inclusion criteria were met by 196 patients. After risk stratification, 48 patients were included in the final analysis (age 54.2 ± 8.1 years; 30 women and 18 men) and were assigned to group A (n = 24) or group B (n = 24). CV occurred less frequently in group B (33%) than in group A (46%). Likewise, DCI was present in 13% in group B compared with 42% in group A. After 12 months, 22 patients in group B had a favorable functional outcome (modified Rankin Scale score 0-3) compared with 15 patients in group A.
In this study, the incidence of CV and DCI was lower in patients receiving intravenous MgSO4 within 24 hours after aneurysmal SAH onset. Favorable functional outcome was more likely in the MgSO4 group after 12 months of follow-up.
摘要：
背景：硫酸镁（MgSO4）是动脉瘤性蛛网膜下腔出血（SAH）患者的潜在神经保护剂。我们分析了术中早期应用硫酸镁的效果，并比较了脑血管痉挛（CV），迟发性脑缺血(DCI),和2个患者队列的神经系统结果。
方法：在诊断后<24小时内未使用（A组）和使用（B组）MgSO4的德国单个中心患者进行了回顾性配对分析。根据DCI和CV的已知危险因素(年龄，费雪等级,吸烟,SAH的严重性)。使用改良的Rankin量表评分记录SAH后3个月和12个月的CV和DCI的发生率以及神经系统预后。
结果：196例患者符合纳入标准。风险分层后，48名患者被纳入最终分析（年龄54.2±8.1岁；30名女性和18名男性），并被分配到A组（n=24）或B组（n=24）。B组(33%)的CV发生率低于A组(46%)。同样，12个月后，B组为13%，A组为42%。与A组的15例患者相比，B组的22例患者具有良好的功能结局（改良的Rankin量表评分0-3）。
结论：在本研究中，在动脉瘤性SAH发病后24小时内接受MgSO4静脉给药的患者中,CV和DCI的发生率较低.在12个月的随访后，MgSO4组更有可能获得有利的功能结果。
方法：在诊断后<24小时内未使用（A组）和使用（B组）MgSO4的德国单个中心患者进行了回顾性配对分析。根据DCI和CV的已知危险因素(年龄，费雪等级,吸烟,SAH的严重性)。使用改良的Rankin量表评分记录SAH后3个月和12个月的CV和DCI的发生率以及神经系统预后。
结果：196例患者符合纳入标准。风险分层后，48名患者被纳入最终分析（年龄54.2±8.1岁；30名女性和18名男性），并被分配到A组（n=24）或B组（n=24）。B组(33%)的CV发生率低于A组(46%)。同样，12个月后，B组为13%，A组为42%。与A组的15例患者相比，B组的22例患者具有良好的功能结局（改良的Rankin量表评分0-3）。
结论：在本研究中，在动脉瘤性SAH发病后24小时内接受MgSO4静脉给药的患者中,CV和DCI的发生率较低.在12个月的随访后，MgSO4组更有可能获得有利的功能结果。
