尼莫地平治疗脑梗死60例临床观察

目的:观察尼莫地平(NMD)治疗脑梗死的疗效。方法:将120例脑梗死入选病例随机分为治疗组和对照组各60例,2组患者均给予常规治疗,使用脱水、神经营养、活血化瘀、降压、调脂、降糖及对症治疗,治疗组在此基础上口服NMD30mg,tid。疗程均为15d。观察2组疗效,治疗前与治疗15d后进行神经功能缺损评分,并行经颅多普勒彩超检测血液流变学改变。结果:治疗组的总有效率为86.7%,明显高于对照组的总有效率(60.0%),2组比较差异有统计学意义(P<0.05);治疗组治疗前、后及2组简易精神状态检查量表(MMSE)、中国卒中量表(CSS)、巴氏指数(BI)评分比较差异均有统计学意义(P<0.05);对照组治疗前、后MMSE评分比较差异有统计学意义(P<0.05);治疗组1个月后的大脑中动脉、前动脉及后动脉的血流速度较治疗前明显增加,且较对照组增加明显,2组比较差异均有统计学意义(P<0.01);2组均未见严重不良反应。结论:NMD治疗脑梗死疗效显著,神经功能恢复好,脑血流量增加更明显,安全性好。

Clinical Observation of Nimodipine for 60 Cases of Cerebral Infarction

OBJECTIVE： To observe the clinical efficacy of nimodipine on cerebral infarction. METHODS： 120 patients with cerebral infarction were randomly selected into treatment group and control group（n=60）. Both groups were given routine therapy, i.e. dehydration, neurotrophy, activating blood and dissolving stasis, lowering blood pressure, regulating blood lipid, lowering blood sugar and symptomatic treatment. Treatment group were additionally given oral dose of nimodipine 30 mg t.i.d. for 15 days. Clinical efficacies of 2 groups were observed and neurological impairment score before treatment and 15 days after treatment were evaluated. The change of hemorheology was detected by transcranial Doppler ultrasonography. RESULTS： The total effective rate of treatment group was 86.7%, which was significantly higher than that of control group（60.0%）, there was significant difference between 2 groups（P〈0.05）. There were statistical significance in difference of MMSE, CSS and MBI score between 2 groups（P〈0.05）. MMSE score of control group before and after treatment difference was statistically significant（P〈0.05）. The blood flow rates of MCA, ACA and PCA in treatment group were increased significantly after 1 month of treatment, there was significant difference between 2 groups（P〈0.01）. No severe ADR was observed in 2 groups. CONCLUSION： Nimodipine has obvious effect on cerebral infarction with good safety and can significantly improve neurological function and cerebral blood flow.