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作者在既往的尸解研究中发现:急性脑梗塞产生脑水肿,导致脑干受压,这是引起34.2%脑梗塞病人死亡的原因.在早期,有关类固醇对中风的疗效报告是相互矛盾的.有的报告部分病人用类固醇治疗后神经系统病情恶化;有的则认为应用类固醇治疗后效果较好,也有报告则显示无效.这些早期的报告由于类固醇剂量低,疗程短,病例少,难以说明问题.但在一些鼠的实验表明:糖皮质类固醇可使神经元产生缺血性损害.近来也曾报告用双盲法对113例急性脑梗塞病人随意进行对照实验提示大剂量的地塞米松治疗无效.为此,作者从近8年在24小时内急性卒中住院病人使用类固醇治疗的病例中,采用随机法进行对照回顾性研究,以评定类固醇的效果.
In a previous autopsy study, the authors found that cerebral infarction produces cerebral edema, which causes compression of the brainstem, which accounts for 34.2% of all deaths from cerebral infarction. In the early days, reports of efficacy of steroids on stroke were conflicting. Some reported worsened neurological status after treatment with steroids, while others considered steroids to be effective and ineffective in reports that were difficult to characterize because of low doses of steroids, short course of treatment and few cases However, experiments in a few rats have shown that glucocorticosteroids cause ischemic damage to neurons, and recently randomized controlled trials of 113 patients with acute cerebral infarction using a double-blind method have shown no effect of high-dose dexamethasone therapy To this end, the authors used a randomized, controlled, retrospective study of steroid effects in patients admitted for acute stroke within 24 hours in the last 8 years.