摘要
目的 探讨地塞米松（DXM）、促肾上腺皮质激素（ACTH）及甲基强的松龙（MP）治疗伽玛刀放疗后肿瘤周围血管源性脑水肿（PVBE）的疗效.方法 对伽玛刀放疗后出现PVBE的脑肿瘤患者采用DXM（26例）、ACTH（22例）和MP（31例）治疗.观察和记录患者肿瘤周围血管源性脑水肿指数（PVBE-E1）、临床疗效及不良反应等指标.结果 采用DXM、ACTH治疗的患者临床症状改善迅速,但药物不良反应严重.停药后短期内可出现严重脑水肿反应.MP治疗的患者治疗时间较长,3～6个月肿瘤病灶基本消失或局部形成脑软化灶,PVBE随之消退.结论 DXM、ACTH和MP均能降低伽玛刀放疗后PVBE.但DXM和ACTH副作用较多,MP副作用最少.其作用机制可能与抑制免疫反应,减轻血管损伤,改善病灶周围脑水肿区域血脑屏障的受损及修复程度有关.
Objective To investigate the efficiency and mechanism of dexamethasone （DXM）,adrenocorticotropic hormone（ACTH ）and methylprednisolone（MP） in the treatment of stubborn peritumoral vasogenic brain edema （PVBE） after γ-knife therapy. Methods The PVBE-EI,clinical effect and side-effect were observed in the case with stubborn PVBE. Results DXM, ACTH and MP were effective to stubborn peritumoral vasogenic brain edema （PVBE） after γ -knife therapy. DXM and ACTH can relief clinical symptom promptly but have serious side-effect.MP has less side-effect compared with DXM and ACTH. Conclusion DXM.ACTH and MP therapy are effective to stubborn peritumoral vasogenic brain edema （PVBE） after y-knife therapy. Its effi- ciency is mainly dependent on the both damaged and repaired degree of brain-blood barrfer in the brain tumors and changed at in a medicine-dependent manner.
出处
《浙江医学》
CAS
2010年第12期1754-1756,共3页
Zhejiang Medical Journal
关键词
肿瘤周围血管源性脑水肿
伽玛刀
激素
脑肿瘤
Peritumoral vasogenic brain edema γ-knife Hormone Intracranial tumor
