尼莫地平对脑出血后缺血性脑损害保护作用的研究

目的探讨脑出血后继发性缺血性脑损害机制以及尼莫地平对脑出血后继发性缺血性脑损害的保护作用。方法60例脑出血患者随机分为尼莫地平组(30例)与常规治疗组(30例),在治疗前后用单光子发射型计算机断层显像(SPECT)观察原发灶缺血体积,血肿周围及脑部其他区域的局部脑血流量(rCBF)变化。结果尼莫地平组和常规治疗组治疗后原发灶缺血的体积明显缩小,原发灶缺血体积减少值尼莫地平组明显高于常规治疗组(P<0.01)。治疗后原发灶及远隔部位缺血灶rCBF增加值尼莫地平组明显高于常规治疗组(P<0.01)。结论脑出血后血肿周围及远隔区域可出现广泛的rCBF下降,血肿周围可能存在缺血半暗带。尼莫地平治疗脑出血有确切疗效,可改善局部脑缺血。

The study of protective effect of nimodipine on brain against ischemic damage after cerebral hemorrhage

Objective To investigate the mechanism of ischemic brain damage after cerebral hemorrhage and to explore the protective effect of nimodipine on brain against ischemic damage after cerebral hemorrhage.Methods Sixty cases of cerebral hemorrhage were randomly divided into nimodipine treatment group and conventional treatment group.The primary ischemic focus volume,regional cerebral blood flow(rCBF) in the area around hematoma and other areas in brain were observed with SPECT.Results After treatment the volume of the primary ischemic focus was reduced apparently in both groups and more reduction was observed in nimodipine treatment group than in conventional treatment group(P<0.01).After treatment,increase in rCBF in the primary ischemic focus and the distant ischemic focus was to a higher degree in nimodipine treatment group than in conventional treatment group(P<0.01).Conclusions The wide-range decrease in rCBF occurs in area around the hematoma and distant area after cerebral hemorrhage.In addition,there may be ischemic penumbra around the hematoma.Nimodipine can improve local cerebral ischemia and has definite efficacy in treatment of cerebral hemorrhage.