国产尼莫地平注射液治疗急性缺血性脑梗塞的临床评价

目的 评价国产尼莫地平注射液治疗急性缺血性脑梗塞的临床疗效及安全性。方法 使用单肓、平行对照、随机的方法,将120例急性缺血性脑梗塞患者分为2组:尼莫地平组(n=60)在使用甘露醇治疗的基础上,加用尼莫地平注射液3 mg/d静脉滴注;对照组(n=60)单用甘露醇治疗。结果 尼莫地平组和对照组总有效率分别为95.0 %和71.7 %,前者明显优于后者(P<0.01)。尼莫地平组病情程度轻型的疗效优于中、重型,病程1天内的疗效优于超过3天的疗效。其疗效不受性别及年龄的影响。尼莫地平组改善神经功能缺损比对照组更迅速、更显著(P<0.01)。尼莫地平组血小板聚集率比治疗前降低15.7%(P<0.01);患侧大脑中动脉(MCA)及大脑前动脉(ACA)的血流速度比治疗前分别增加15.4 %及11.4 (P均<0.05)。对照组对血小板聚集、脑血流速度无明显影响(P> 0.05) 。尼莫地平组不良反应以头痛、头晕为主,其发生率低,与对照组无统计学差异(P>0.05)。结论 国产尼莫地平注射液治疗急性缺血性脑梗塞的疗效确切、作用迅速、无明显不良反应,是有价值的治疗药物。

Clinical evaluation of treatment of acute ischemic cerebreal infarction with intravenous nimodipine

Aim This study was designed to evaluate the effect of nimodipine on acute ischemic cerebral in-farction and its safety. Methods With single - blind, paralle controll and random methods 120 patients with acute ischemic cerebral infarction were equally divided into 2 groups. Patients in ni-modipine group (n = 60)received nimodipine 3 mg/d by intravenous infusion as well as mannitol, for 21 days. Patients in control group (n = 60) received only mannitol for 21 days. Results The rates of effect in nimodipine and control groups were 95.0 % and 71.7 %,respectively. There was a significant difference (P< 0.01) between the two groups. The improvement of nervous functional defect was obvious and rapid in the nimodipine group compared with that in the control group (P <0.01). Platelet aggregation rate after treatment decreased by 15.7 % compared with that before treatment in nimodipine group (P< 0.01); Cerebral blood flow velocity of arteriae cerebri media (MCA) and arteriae cenebri anterior (ACA) increased by 15.4 % and 11.4 % respectively compared with those before treatment (P< 0.05). Platelet aggregation rate and cerebral blood flow velocity in control group were not affected (P< 0.05). The commonest adverse effects in the two groups were headache and diziness. No patient withdrew from the treatment due to the adverse reactions. Conclusion Nimodipine, administered by intravenous infusion, has shown to be a relatively safe and rapidly effective drug for trea tment of patients with acute ischemic cerebral infarction.