尼莫地平对高血压性脑出血破入脑室患者脑循环动力学参数的影响  

Effect of Nimodipine on Cerebrovascular Hemodynamics Parameters in Patients with Intraventricular Hemorrhage Secondary to Hypertensive Cerebral Hemorrhage

作　　者：袁州[1] 张一凡[2] 张忠雷[2] 

机构地区：[1]上海中医药大学附属曙光医院松江分院,上海201600 [2]上海市松江区中心医院神经内科,上海201600

出　　处：《神经病学与神经康复学杂志》2006年第3期131-133,141,共4页Journal of Neurology and Neurorehabilitation

摘　　要：目的探讨尼莫地平治疗高血压性脑出血破入脑室的疗效和作用机制。方法用尼莫地平治疗高血压性脑出血破入脑室患者,比较治疗组与对照组的脑循环动力学参数、治疗有效率、头颅 CT 片上的血肿量和水肿面积大小。结果治疗组用药后脑循环动力学参数中的平均血流速度(Vmean)、平均血流量(Qmean)值较对照组用药后有明显的增高(P<0.05),外周血管阻力(R)、临界压力(CP)较对照组明显下降(P<0.01),其中 Vmean、Qmean、R 与 CP 值在治疗组治疗后双侧无明显差异;治疗组的治疗好转例数明显较对照组高;治疗组治疗前后的水肿面积积分差、血肿量积分差与对照组没有明显差异。结论尼莫地平治疗高血压性脑出血破入脑室者具有增加脑血流量、降低脑血管阻力、调节脑血管功能、减少可能的广泛脑血管痉挛、提高近期治疗效果作用,但对血肿量和水肿面积无作用。Objective To study the effect and mechanism of nimodipine in the treatment of patients with intra- ventricular hemorrhage.Methods Patients with intraventricular hemorrhage secondary to hypertensive cerebral hemorrhage were randomly divided into the therapeutic group and the control group.Both groups were treated conven- tionally,while nimodipine was added to the therapeutic group.In contrast,several parameters,including cerebrovas- cular hemodynamics indexes,short-term therapeutic effective rate,hematoma volume and the area of edema on the CT scan were detected or measured in the two groups.Results Compared with the control group,Vmean and Qmean were increased significantly while R and CP decreased significantly after treatment in the therapeutic group. There were no significant differences among bilateral Vmean,Qmean,R and CP after treatment in the therapeutic group.There were no significant differences in short-term therapeutic effective rates,hematoma volume or the area of edema between the two groups.Conclusion Nimodipine has the effect of increasing cerebral blood supply,decrea- sing cerebrovascular resistance,adjusting cerebrovascular function,decreasing the possibility of cerebrovascular vaso- spasm,and increasing short-term therapeutic effect in patients with intraventricular hemorrhage secondary to hyperten- sive cerebral hemorrhage.It has no effect on hematoma volume and the area of edema.

关 键 词：脑循环动力学指标 尼莫地平 高血压 脑出血 脑室出血 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]