PENGARUH PENAMBAHAN ASAM ASKORBAT INTRAVENA PADA TERAPI STANDAR STROKE ISKEMIK FASE AKUT TERHADAP PERBAIKAN STATUS NEUROLOGIS

Abstract

Background: Toward ischemic stroke, brain suffers from oxidative stress that have a role on cellular damage. Body needs more antioxidant to predominate cellular damage. The aim of this study is to discover ascorbic acid supplementation influence in acute ischemic stroke standard therapy toward of status neurological improvement. Methods: A double blind, pre and post test randomized control trial study in January-November 2006. Subjects were 100 acute ischemic stroke patients hospitalized in neurology ward Dr. Kariadi hospital, divided into 2 groups: those who accept standard therapy + placebo (n=50) and those who accept standard therapy + ascorbic acid 200 mg intravenous daily (n=50) for 7 days. The severity of neurological deficit was measured by NIHSS administered on admission (day- 0), 7 and 14. The alteration of score was analysed and compared between groups. Results : The NIHSS decrease was bigger in vitamin group than placebo group. The NIHSS mean and median in placebo group vs vitamin group on day-0, 7 and 14: 17,6(16) vs 17,8(18), 17,1(16) vs 16,2(16), and 16,7(16) vs 14,6(15). The NIHSS difference was statistically significant (p <0.05) based on Mann-Whitney test. Delta of NIHSS decrease in vitamin group was statistically significant than placebo group (p<0,001) based on Friedman test. The value of RRR was 100%, ARR 8%, NNT 1. Conclusions : Supplementation of ascorbic acid 200 mg intravenous daily for 7 days in acute ischemic stroke standard therapy gives better improvement in status neurological based on NIHSS. Key Words: Ischemic stroke - Oxidative stress - Ascorbic acid.