法舒地尔与尼莫地平在颈动脉支架置入术中预防脑血管痉挛的作用

目的比较法舒地尔和尼莫地平在颈动脉支架置入术(CAS)中预防脑血管痉挛的作用。方法回顾性纳入532例接受单侧CAS的患者,按照给予药物的不同,分为尼莫地平组(184例,10 mg尼莫地平加入500 ml等渗盐水中,持续缓慢静脉滴注)和法舒地尔组(348例,30 mg法舒地尔加入250 ml等渗盐水中,持续缓慢静脉滴注),观察术中血管痉挛、症状性低血压、围手术期卒中和死亡的发生情况。结果①法舒地尔组术中无血管痉挛发生的患者比例高于尼莫地平组(85.1%比77.7%),无症状性血管痉挛的发生率低于尼莫地平组(13.8%比20.7%),两组比较差异均有统计学意义(P<0.05)。②法舒地尔组术中症状性低血压的发生率低于尼莫地平组(10.6%比19.0%),差异有统计学意义,P<0.05。③两组症状性血管痉挛、围手术期卒中和死亡发生率的比较,差异均无统计学意义,P>0.05。结论与尼莫地平相比,盐酸法舒地尔组脑血管痉挛的发生率较低,同时对血压影响较小。

Comparative study of fasudil and nimodipine for prevention of cerebral vasospasm during carotid artery stenting

Objective To compare the effect of fasudil and nimodipine on the prevention of cerebral vasospasm during carotid artery stenting （CAS）. Methods A total of 532 patients treated with unilateral CAS were enrolled retrospectively. According to the administration of different drugs, they were divided into either a nimodipine group （n=184） or a fasudil group （n=348 ）. The occurrence of intraoperative vasospasm, symptomatic hypotension, peri0Perative stroke, and fatality were observed. Results ①The proportion of patients without vasospasm during the procedure in the fasudil group was higher than that in the nimodipine group （85.1% vs77.7% ）, and the incidence of patients with asymptomatic vasospasm was lower than that in the nimodipine group （ 13.8% vs20.7% ）. There was significant difference between the 2 groups （ P 〈 0.05 ）. ②The incidence of symptomatic hypotension during the procedure in the fasudil group was lower than that in the nimopine group （ 10.6% vs. 19.0% ）. There was significant difference （P 〉 0.05 ）. ③There were no significant differences in the incidences of symptomatic vasospasm, perioperative stroke and fatality between the 2 groups （P 〉 0.05）. Conclusion Compared to nimodipine, the incidence of cerebral vasospasm is lower in the fasudil group, and has less impact on the blood pressure.