Observation of clinical effects of recombinant human erythropoietin combined with methylprednisolone sodium succinate in the treatment of acute spinal cord injury

Abstract

Objective To evaluate the effect of recombinant human erythropoietin (rhEPO) combined with methylprednisolone sodium succinate (MPSS), compared to MPSS alone, in the treatment of neurological function of patients with acute spinal cord injury (SCI). Methods Twenty-one patients presenting in hospital within less than 8 hours after acute SCI were randomly divided into two groups, the control group (10 cases) and the intervention group (11 cases). The control group was treated by MPSS combined with placebo, while the intervention group received MPSS with rhEPO.Both groups received MPSS 30 mg/kg within the first hour, and if the patient was admitted within 4 hours, MPSS would be applied in the treatment with 5.4 mg/kg per hour in the subsequent 23 hours and till 47 hours if the patient was admitted within 4-8 hours after injury.The intervention group received 500 U/kg rhEPO on admission and another 500 U/kg in the next 24 hours, compared with the control group where placebo was used.The evaluation on neurologic function recovery was made on admission, 24 h, 72 h, one week, 2 months and 6 months later, and statistical analysis was performed. Results The change in ASIA score: in the control group, the increase was seen from admission to 6 months after injury in terms of exercise, algesia and tactile sensation ( (31.2±6.6) points vs.(57.8±9.8) points, (41.4±9.5) points vs.(64.3±10.6) points, (39.2±6.8) points vs, (61.5±11.3) points), the increase also took place in the intervention group ( (29.5±7.2) points vs.(77.4±10.3) points, (39.7±7.2) points vs.(82.3±12.1) points, (37.4±6.2) points vs.(78.6±12.4) points). As time went on, the increase range in the intervention group became larger, compared with the control group.The difference between the two groups in ASLA score was statistically significant (P 0.05). Conclusion The application of MPSS combined with rhEPO within 8 hours after acute spinal injury may be more effective than MPSS with placebo in the neurologic dysfunction recovery. Key words: Recombinant human erythropoietin; Methylprednisolone sodium succinate; Spinal cord injury