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Combination of Serine Protease Inhibitor FUT-175 and Thromboxane Synthetase Inhibitor OKY-046 Decreases Cerebral Vasospasm in Patients with Subarachnoid Hemorrhage


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Title: Combination of Serine Protease Inhibitor FUT-175 and Thromboxane Synthetase Inhibitor OKY-046 Decreases Cerebral Vasospasm in Patients with Subarachnoid Hemorrhage
Authors: Kaminogo, Makio / Yonekura, Masahiro / Onizuka, Masanari / Yasunaga, Akio / Shibata, Shobu
Issue Date: 15-Nov-1998
Publisher: The Japan Neurosurgical Society / 日本脳神経外科学会
Citation: Neurologia medico-chirurgica, 38(11), pp.704-709; 1998
Abstract: クモ膜下出血後(SAH)の脳血管攣縮発現に補体活性化を介する炎症反応が関与するとの考えらか、抗補体活性化作用を有するserine protease inhibitor(FUT-175)を従来の抗攣縮治療であるTXA2合成阻害薬(OKY-046)とともに使用し、その有効性に関しFisher group 3の高度なクモ膜下出血症例を対象として検討した。その結果FUT-175とOKY-046の併用は、OKY-046単独使用に比べ、Hunt and Hess IIIとIVの症例において有意に血管攣縮発現を抑制し(<0.02)、Hunt and Hess Vを除くoverallの予後を有意に改善した(<0.05)。FUTの使用はSAH発症48時間以内、1日80mg以上が有効であった。 / The preventive effect of the serine protease inhibitor FUT-175 (nafamostat mesilate), a potent inhibitor of the complement system, against vasospasm was evaluated in 34 high risk patients with thick and diffuse subarachnoid hemorrhage (SAH) demonstrated by computed tomography corresponding to Fisher group 3. All patients underwent surgery within 96 hours following SAH and received the thromboxane A_2 synthetase inhibitor, OKY-046, as part of standard care. FUT-175 (40-160 mg/day) was administered during the initial 4 days following surgery. 455 patients treated without FUT-175 in the Nagasaki SAH Data Bank (non-FUT group) formed the control group. FUT-175 significantly decreased the incidence of symptomatic vasospasm in patients with severe neurological grade (Hunt and Hess grade 3, p<0.02 ; Hunt and Hess grade 4, p<0.02). The incidence of favorable outcome was 76.5% in the FUT group and 60.4% in the non-FUT group, but not statistically different. However, when patients of Hunt and Hess grade 5 were excluded, the FUT group had a significantly improved outcome (p<0.05). This study suggests that FUT-175 has an additive effect to OKY-046 in preventing vasospasm in high risk patients with severe SAH.
Keywords: cerebral aneurysm / serine protease inhibitor / subarachnoid hemorrhage / thromboxane A_2 synthetase inhibitor / vasospasm
URI: http://hdl.handle.net/10069/23659
ISSN: 04708105
Relational Links: http://ci.nii.ac.jp/naid/110002277473/
Rights: 日本脳神経外科学会 / 本文データは学協会の許諾に基づきCiNiiから複製したものである
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/23659

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