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Rapid Intervention of Chlorpromazine and Promethazine for Hibernation-Like Effect in Stroke: Rationale, Design, and Protocol for a Prospective Randomized Controlled Trial

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机构: [1]Luhe Institute of Neuroscience, Capital Medical University, Beijing, China [2]Department of Neurology, Beijing Luhe Hospital,Capital Medical University, Beijing, China [3]China-America Institute of Neuroscience, Xuanwu Hospital, Capital MedicalUniversity, Beijing, China [4]Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI,United States [5]Department of Neurosurgery, Munson Medical Center, Traverse City, MI, United States [6]Department ofResearch and Development Center, John D. Dingell VA Medical Center, Detroit, MI, United States
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关键词: acute ischemic stroke (AIS) phenothiazine neuroprotection intravenous thrombolysis rt-PA

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Background: Following an acute ischemic stroke (AIS), rapidly initiated reperfusion therapies [i. e., intravenous thrombolysis (IVT) and endovascular treatment (EVT)] demonstrate robust clinical efficacy. However, only a subset of these patients can benefit from these therapies due to their short treatment windows and potential complications. In addition, many patients despite successful reperfusion still have unfavorable outcomes. Thus, neuroprotection strategies are urgently needed for AIS patients. Chlorpromazine and promethazine (C+P) have been employed in clinical practice for antipsychotic and sedative purposes. A clinical study has also shown a neuroprotective effect of C+P on patients with cerebral hemorrhage and subarachnoid hemorrhage. The safety, feasibility, and preliminary efficacy of intravenous administration of C+P in AIS patients within 24 h of onset will be elucidated. Methods: A prospective randomized controlled trial is proposed with AIS patients. Participants will be randomly allocated to an intervention group and a control group with a 1:1 ratio (n = 30) and will be treated with standard therapies according to the current stroke guidelines. Participants allocated to the intervention group will receive intravenous administration of C+P (chlorpromazine 50 mg and promethazine 50 mg) within 24 h of symptom onset. The primary outcome is safety (mainly hypotension), while the secondary outcomes include changes in functional outcome and infarction volume. Discussions: This study on Rapid Intervention of Chlorpromazine and Promethazine for Hibernation-like Effect in Stroke (RICHES) will be the first prospective randomized controlled trial to ascertain the safety, feasibility, and preliminary efficacy of intravenous C+P as a neuroprotection strategy in AIS patients. These results will provide parameters for future studies, provide insights into treatment effects, and neuroprotection with phenothiazine in AIS.

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基金编号: 82072549 82001277 KJ2020CX002

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 神经科学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 神经科学
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出版当年[2019]版:
Q2 CLINICAL NEUROLOGY Q3 NEUROSCIENCES
最新[2023]版:
Q2 CLINICAL NEUROLOGY Q3 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者机构: [1]Luhe Institute of Neuroscience, Capital Medical University, Beijing, China [2]Department of Neurology, Beijing Luhe Hospital,Capital Medical University, Beijing, China
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通讯机构: [1]Luhe Institute of Neuroscience, Capital Medical University, Beijing, China [2]Department of Neurology, Beijing Luhe Hospital,Capital Medical University, Beijing, China [3]China-America Institute of Neuroscience, Xuanwu Hospital, Capital MedicalUniversity, Beijing, China [4]Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI,United States
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