| Preventive Effects of Ulinastatin on Vasospasm following Spontaneous Subarachnoid Hemorrhage |
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Jiin Kang , Soonki Hong , Chul Hu , Jinsoo Pyen , Kum Whang , Sungmin Cho , Jongyeon Kim , Sohyun Kim , Jiwoong Oh |
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Department of Neurosurgery, Yonsei University Wonju College of Medicine, Wonju, Korea |
| 자발성 지주막하 출혈 시 우리나스타틴(Ulinastatin)이 가지는 뇌혈관 연축 예방 효과 |
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강지인·홍순기·허 철·변진수·황 금·조성민·김종연·김소현·오지웅 |
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연세대학교 원주의과대학 신경외과학교실 |
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| Abstract |
Objective
The pathological mechanism of vasospasm is not yet fully understood, however, numerous literatures have unrevealed and explained the various components in triggering the propagations of vasospasm such as Tumor Necrosis Factor-α, Interleukin-6, Interleukin-1β, Nitric Oxide and so on, some of which were reported that can be regulated by ulinastatin. Thus, we attempted to investigate the role of ulinastatin in vasospasm following Spontaneous subarachnoid hemorrhage (S-SAH).
Methods
We retrospectively studied 94 S-SAH patients who treated with endovascular embolization in our hospital from March, 2010 to March,2014. All patients were evaluated with transcranial doppler (TCD) during 2 weeks from admission. We classified these 94 patients into two groups based on the use of ulinastatin, then analyzed them with the following factors: gender, age, initial Glasgow coma scale (GCS), Glasgow outcome score (GOS), hemispheric index ratio, Fisher grade, intensive care unit (ICU) stay period, mean velocity of TCD.
Results
Of the 94 S-SAH patients, ulinastatin was injected intravenously to 26 patients (27.7%) while the remaining 68 patients (72.3%) were not used. Lindegaard ratio of ulinastatin used group is 2.33, but 3.08 in non-used group. (p=0.0026) Mean velocity on TCD is 82.69±33.08 cm/s in ulinastatin used group, 92.466±35.43 cm/s in non-used group. But the difference showed no statistical significance (p=0.5537).
Conclusion
Our data suggests that the use of the ulinastatin could be helpful for protection from vasospasm following S-SAH. |
| Key Words:
Spontaneous subarachnoid hemorrhageㆍCerebral vasospasmㆍUlinastatin |
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