尼莫地平对急性脑梗塞患者脑血管功能的影响

目的用脑循环动力学指标（ＣＶＤＩ）评价尼莫地平静脉滴注对急性脑梗塞（ＡＣＩ）患者脑血管功能影响,并系统观察其对血压、心率及心电图的影响。方法选取发病时间在７２小时以内的颈内动脉系统ＡＣＩ患者３０例,每天静脉滴注尼莫地平（１０ｍｇ,０２５～０．５μｇ·ｋｇ－１ｍｉｎ）,疗程１４天。于治疗中不同时间分别观察ＣＶＤＩ、血压、心率、心电图的变化。结果（１）尼莫地平可明显改善脑血管功能,表现在脑供血增加,脑血管阻力及临界压力下降,脑血管弹性及自动调节功能改善;（２）用药第３天血压明显下降,以后保持相对稳定;第１４天心率下降（Ｐ＝０．０１１）;（３）尼莫地平静脉滴注的时间以１０天左右为宜。结论尼莫地平静脉滴注可明显改善ＡＣＩ患者的脑血管功能,但用药中应加强血压及心电图监护。

The effects of nimodipine on cerebrovascular function in acute cerebral infarction

OBJECTIVES: To use cerebrovascular hemodynamics indexes (CVDI) to evaluate the effects of nimodipine on cerebrovascular function in acute cerebral infarction (ACI), and to investigate the changes of blood pressure (BP), heart rate (HR), and electrocardiography (ECG). METHODS: 30 patients with ACI in internal carotid artery system within 72 h from the oneset of symptoms were given nimodipine (10 mg, 0.25-0.5 microgram/kg/min) by intravenous drip (i.v.) every day for 14 days. CVDI, BP, HR and ECG were examined at various times during treatment. RESULTS: Nimodipine improved cerebrovascular function significantly. Cerebral blood velocity and flow increased, cerebrovascular resistance and criticle pressure decreased, and cerebrovascular elasticity and autoregulation improved. BP dropped significantly at the third day, and mainteined stable afterward. HR dropped remarkably at the fourteen day (P = 0.011). It was reasonable that the treatment of nimodipine (i.v.) lasted 10 days or so. CONCLUSIONS: Nimodipine improves cerebrovascular function significantly, but monitoring of BP and ECG is necessary during its application.