目的:探讨甘露醇对缺血性脑水肿患者肾功能的影响。方法:连续入选2019年1月—2021年3月在该院治疗的150例缺血性脑水肿患者,按照甘露醇剂量的不同分为研究组和对照组,各75例。对照组采用20%甘露醇250 ml治疗,研究组采用20%甘露醇125 ml...目的:探讨甘露醇对缺血性脑水肿患者肾功能的影响。方法:连续入选2019年1月—2021年3月在该院治疗的150例缺血性脑水肿患者,按照甘露醇剂量的不同分为研究组和对照组,各75例。对照组采用20%甘露醇250 ml治疗,研究组采用20%甘露醇125 ml治疗,比较两组治疗前后水肿体积、颅内压、美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分(GCS)和急性肾功能衰竭发生情况。结果:两组治疗后水肿体积、颅内压、NIHSS、GCS评分较治疗前改善,但组间比较,差异无统计学意义(P>0.05)。研究组治疗第5、10天急性肾功能衰竭发生率低于对照组,差异有统计学意义(P<0.05)。结论:250 ml与125 ml 20%甘露醇治疗缺血性脑水肿的临床疗效相当,但125 ml 20%甘露醇对肾功能的损伤小,安全性更高。展开更多
Objective: To study the correlation between aquaporin-4 ( AQP4) expression and diffusion-weighted imaging ( DWI) in the process of ischemic brain edema for the molecular biologic mechanism of DWI. Methods: A total of ...Objective: To study the correlation between aquaporin-4 ( AQP4) expression and diffusion-weighted imaging ( DWI) in the process of ischemic brain edema for the molecular biologic mechanism of DWI. Methods: A total of 34 Wistar rats were divided into 8 groups randomly: Non-operated group (n = 4) , sham-operated group (n = 6) , and operated group, receiving right middle cerebral artery occlusion ( MCAO) for 15 and 30 min, and 1,3,6 and 24 h respectively (6 subgroups, n =4). All groups were imaged with DWI and T2WI. The apparent diffusion coefficient (ADC) , relevant density (rd) and relevant area (rs) of hyperintensity of the lesions on DWI and T2WI were measured. Relevant ADC (rADC) , relevant area of immunohistochemical staining for AQP4 (rS) , optical density of AQP4 hybridization (a) were calculated. After that the animals were sacrificed and perfused at different time intervals, correlations between DWI, ADC, and AQP4 expression (rS, a) in ischemic tissue was made. Results: There was a significant correlation between rS and a ( r = 0. 949 ). The abnormal high intensity was found in DWI of the ipsilateral MAC territory at 15 min after MCAO. The ADC value decreased quickly within 1 h after MCAO, the rd and rs of DWI increased rapidly and the expression of AQP4 increased quickly, too. However, there was no change on the T2WI. In the period of time (15 min - 1 h) , the AQP4 expression( a) had a strong relation to the rd and rs( r = 0. 914, 0. 895). With the progress of the time, the ADC value of MCAO decreased further to (2.1±0.6)×10-4 mm2/s at 3 h, and then followed an increased slowly till 24 h, but the rd and the rs as well as the expression of AQP4 continuously increased during the stage. The T2WI detected the lesion at the average time (1.4 h) after MCAO, and the rs of T2WI was less than that of DWI at the same time in the same layer (P < 0.05). Conclusion: The results imply that high expression of AQP4 may play a key role in ischemic brain edema. It is, certainly, one of the important reasons of the DWI mo展开更多
文摘目的:探讨甘露醇对缺血性脑水肿患者肾功能的影响。方法:连续入选2019年1月—2021年3月在该院治疗的150例缺血性脑水肿患者,按照甘露醇剂量的不同分为研究组和对照组,各75例。对照组采用20%甘露醇250 ml治疗,研究组采用20%甘露醇125 ml治疗,比较两组治疗前后水肿体积、颅内压、美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分(GCS)和急性肾功能衰竭发生情况。结果:两组治疗后水肿体积、颅内压、NIHSS、GCS评分较治疗前改善,但组间比较,差异无统计学意义(P>0.05)。研究组治疗第5、10天急性肾功能衰竭发生率低于对照组,差异有统计学意义(P<0.05)。结论:250 ml与125 ml 20%甘露醇治疗缺血性脑水肿的临床疗效相当,但125 ml 20%甘露醇对肾功能的损伤小,安全性更高。
基金Supported by the National Natural Science Foundation of China(No.30070247)
文摘Objective: To study the correlation between aquaporin-4 ( AQP4) expression and diffusion-weighted imaging ( DWI) in the process of ischemic brain edema for the molecular biologic mechanism of DWI. Methods: A total of 34 Wistar rats were divided into 8 groups randomly: Non-operated group (n = 4) , sham-operated group (n = 6) , and operated group, receiving right middle cerebral artery occlusion ( MCAO) for 15 and 30 min, and 1,3,6 and 24 h respectively (6 subgroups, n =4). All groups were imaged with DWI and T2WI. The apparent diffusion coefficient (ADC) , relevant density (rd) and relevant area (rs) of hyperintensity of the lesions on DWI and T2WI were measured. Relevant ADC (rADC) , relevant area of immunohistochemical staining for AQP4 (rS) , optical density of AQP4 hybridization (a) were calculated. After that the animals were sacrificed and perfused at different time intervals, correlations between DWI, ADC, and AQP4 expression (rS, a) in ischemic tissue was made. Results: There was a significant correlation between rS and a ( r = 0. 949 ). The abnormal high intensity was found in DWI of the ipsilateral MAC territory at 15 min after MCAO. The ADC value decreased quickly within 1 h after MCAO, the rd and rs of DWI increased rapidly and the expression of AQP4 increased quickly, too. However, there was no change on the T2WI. In the period of time (15 min - 1 h) , the AQP4 expression( a) had a strong relation to the rd and rs( r = 0. 914, 0. 895). With the progress of the time, the ADC value of MCAO decreased further to (2.1±0.6)×10-4 mm2/s at 3 h, and then followed an increased slowly till 24 h, but the rd and the rs as well as the expression of AQP4 continuously increased during the stage. The T2WI detected the lesion at the average time (1.4 h) after MCAO, and the rs of T2WI was less than that of DWI at the same time in the same layer (P < 0.05). Conclusion: The results imply that high expression of AQP4 may play a key role in ischemic brain edema. It is, certainly, one of the important reasons of the DWI mo
