硝酸酯类与钙拮抗剂对抗高压氧诱发脑梗死形成的预防作用比较

背景高压氧可诱发脑梗死形成,但以何种药物预防以及药物的预防作用尚不清楚.目的比较硝酸酯类及钙拮抗剂对高压氧诱发脑梗死形成的预防作用.设计以患者为研究对象设立对照的回顾性观察.单位解放军广州军区广州总医院的高压氧科和神经内科.对象广州军区广州总医院行高压氧治疗的的192例住院患者及其中发生脑血栓形成的6例患者,其中男127例,女65例,年龄9～78岁.方法将192例行高压氧治疗的患者分为3组①硝酸酯类组34例.②钙拮抗组49例.③未特殊用药组109例.以年龄≥60岁、原有高血压病、高脂血症、脑梗死(或脑出血)、高黏血症和糖尿病为危险因子,在不同危险因子簇集水平上分析药物的预防作用.干预对192例行高压氧治疗的3组患者在使用常规治疗药物的前提下,硝酸酯类组口服消心痛或硝酸甘油,钙拮抗剂组口服西比灵或络活喜等,未特殊用药组则没有预防性使用药物.主要观察指标危险性指标为脑血栓形成危险因子.结果簇集4个以下危险因子者无一例发生脑血栓形成,在簇集4个及以上危险因子的水平上,硝酸酯类药物有良好的预防作用,而钙拮抗剂组中有33.3%发病,二者差异有显著性意义(P＜0.05).结论硝酸酯类药物有显著的预防作用,而钙拮抗剂无此作用.

Nitrates versuscalcium antagonists in preventing cerebral infarction induced by hyperbaric oxygen

BACKGROUND: Hyperbaric oxygen may induce cerebral infarction. But what kind of medicine may prevent it and what is the preventive function of the medicine are not clear yet.OBJECTIVE: To compare the preventive function of nitrates with calcium antagonists in cerebral infarction induced by hyperbaric oxygen.DESIGN: Controlled retrospective observation based on patients.SETTING: Department of Hyperbaric Oxygen, Department of Neurology,Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 192 patients receiving hyperbaric oxygen treatment in Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA, who were 127 males and 65 females, and aged 9 -78 years old. Among them, 6 patients developed into cerebral infarction.METHODS: Totally 192 patients receiving hyperbaric oxygen treatment were old, hypertensive disease, hyperlipemia, cerebral infarction(or cerebral hemorrhage), hyperviscosity in blood and diabetes as dangerous factors, prevention function of medicine was analyzed on the level of grouping different dangerous factors.INTERVENTIONS: Under the prerequisite condition of regular treatment medicine given to the 192 patients of the 3 groups, patients in nitrate group took isosorbide dinitrate or nitroglycerin orally, patients in calcium antagonist group took sibelium or Norvasc and so on orally, and patients in group without special medication did not take preventive drugs.MAIN OUTCOME MEASURES: Dangerous index was dangerous factorsto cerebral infarction.RESULTS: No one developed into cerebral infarction with grouping less than 4 dangerous factors. On the level of grouping 4 or more dangerous factors,nitrates had good preventive function, but in calcium antagonist group,33.3% patients developed into cerebral infarction. There was significant difference between them( P ＜ 0.05).CONCLUSION: Nitrates have significant preventive functions, but calcium antagonists have no such functions.