ABSTRACT
This study examined the sodium nitroprusside (SNP) toxicity to central nervous system (CNS) in treatment of patients with aortic dissection (AD). The medical records of 191 AD patients who were admitted to Tongji Hospital, China, from Jan. 1998 to Feb. 2009 were retrospectively analyzed. There were 140 cases of hypertension (73.3%) and 13 cases of Marfan syndrome (6.8%) among the 191 AD patients. A total of 157 patients were given SNP treatment. The toxic reactions of CNS occurred in 18 subjects (11.5%). Most of the adverse reactions occurred on the fifth day following SNP injection. SNP infusion rate was significantly higher in patients who developed CNS toxicity. It was suggested that systemic hypertension is the most common predisposing factor for AD. The combination of SNP with a β-receptor blocker is a medical therapy commonly used in patients with AD. Cyanide and thiocyanate toxicity from SNP treatment is always the consequence of prolonged drug infusion or relatively high dose administration.
ABSTRACT
This study examined the sodium nitroprusside (SNP) toxicity to central nervous system (CNS) in treatment of patients with aortic dissection (AD). The medical records of 191 AD patients who were admitted to Tongji Hospital, China, from Jan. 1998 to Feb. 2009 were retrospectively analyzed. There were 140 cases of hypertension (73.3%) and 13 cases of Marfan syndrome (6.8%) among the 191 AD patients. A total of 157 patients were given SNP treatment. The toxic reactions of CNS occurred in 18 subjects (11.5%). Most of the adverse reactions occurred on the fifth day following SNP injection. SNP infusion rate was significantly higher in patients who developed CNS toxicity. It was suggested that systemic hypertension is the most common predisposing factor for AD. The combination of SNP with a β-receptor blocker is a medical therapy commonly used in patients with AD. Cyanide and thiocyanate toxicity from SNP treatment is always the consequence of prolonged drug infusion or relatively high dose administration.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Aorta , General Surgery , Central Nervous System , Nitroprusside , Therapeutic UsesABSTRACT
Objective To investigate the association between elevated levels of hsCRP and prognosis after stroke in Chinese patients.Methods Two hundred and ninety consecutive patients with firstonset stroke(197 ischemic and 93 hemorrhagic)and 290 age-and sex-matched control subjects without any cerebrovascular disease were studied.Plasma hsCRP level was measured and subsequent vascular events and death were determined in both groups over a 5-year period.Results Compared to control group,patients with stroke had higher plasma hsCRP level((3.3 ±3.8)vs(1.3±2.2)mg/L,t=8.048,P<0.01).Furthermore.within the group of patients with stroke,the mean plasma hsCRP level was higher in patients who experienced subsequent vascular events or death compared to patients without further complications ((4.4±4.3)vs(2.7±3.3)mg/L,t=3.496,P=0.001).Compared to the patients with lower hsCRP level(<1 mg/L),the relative risk for vascular events and death in stroke patients was 2.807(95%CI 1.544-5.495,P=0.001)in the hish hsCRP(>3 mg/L)patients.This increase of relative risk for vascular events and death in stroke patients persisted after the adjustment for age,sex and other cardiovascular risk factors such as hypertension and diabetes(OR 2.661,95%CI 1.323-5.352.P=0.006).Conclusions Patients presenting with stroke have higher levels of hsCRP compared to agematched controls.The degree of hsCRP elevation is correlated with the likelihood of subsequent VasCular events and death.These findings indicate that inerease of hsCRP level is associated with worsening prognosis after stroke in Chinese patients.