Title：The End of Steroids for Acute Spinal Injury?


题目：是结束对急性脊髓损伤应用激素的时候了
Author 作者: Feng Xiao (肖锋)
For those Emergency Physicians that work in hospitals where protocols still call for steroids for spinal cord injury, or work with neurosurgeons who still believe in the efficacy of such treatment, a recent statement in Neurosurgery would seem to put the issue to rest:
对于那些在还使用类固醇治疗脊髓损伤的医院工作或医院的神经外科医生仍然相信这种治疗的疗效的急诊医生，《神经外科》杂志的一个最近的声明将终止对这一问题的疑惑：
“Administration of methylprednisolone (MP) for the treatment of acute spinal cord injury (SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not FDA approved for this application. There is no Class I or Class II medical evidence supporting the clinical benefit of MP in the treatment of acute SCI. Scattered reports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and III evidence exists that high-dose steroids are associated with harmful side effects including death.”
“在治疗急性脊髓损伤（SCI）时，不要用甲基强的松龙（MP）。还在考虑用MP治疗的医师应该记住这种药物在SCI中的应用并没有得到FDA的批准。另外还没有I类或II类临床证据支持MP治疗急性脊髓损伤。仅有的几个III类证据报道的效果也不一致，可能与随机机会或病人选择差异所致。然而，确有I，II和III类的证据证实高剂量的类固醇具有有害的副作用，包括死亡。”
Reference 参考文献:
Hurlbert RJ, et al. Neurosurgery 2013 Mar;72 Suppl 2:93-105