《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (07): 540-542.

• 专题 • 上一篇    下一篇

尼莫地平治疗蛛网膜下腔出血脑循环动力学参数的研究

汪慧; 曹贵方; 何雯; 张井红; 夏一鲁; 沈扬   

  1. 清华大学第一附属医院神经内科 北京市 100016
  • 收稿日期:2005-03-25 出版日期:2005-07-25 发布日期:2005-07-25

Value of cerebrovascular hemodynamic indexes in the dosing of nimodipine followed subarachnoid hemorrhage

WANG Hui, CAO Gui-fang, HE Wen,et al   

  1. Department of Neurology, the First Hospital of Tsinghua University, Beijing 100016, China
  • Received:2005-03-25 Published:2005-07-25 Online:2005-07-25

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被引次数

16

摘要： 目的用脑循环动力学参数(CVAI)监测不同剂量尼莫地平静脉滴注对蛛网膜下腔出血(SAH)患者脑血管功能影响,评价CVAI指导尼莫地平在SAH中的应用剂量的临床价值。方法SAH患者58例,入院后持续静脉滴注尼莫地平(0.25μgkg·min),于入院后3～6d经NIHSS评分,将评分≥1分者28例随机分为两组:尼莫地平原剂量组、尼莫地平加量组(0.5μg/kg·min)。分别于治疗前、治疗后1d、7d、14d进行CVAI评估及NIHSS评分。结果尼莫地平可增加脑血流量,降低脑血管阻力(R及临界压力(CP)。对于有神经功能缺损的患者,增加尼莫地平的剂量,可以显著降低R值(P<0.05),减轻神经功能缺损(P<0.05)。结论SAH患者尼莫地平剂量需个体化,脑血流动力学参数R值是调整尼莫地平剂量的重要参考指标。

关键词: 尼莫地平, 蛛网膜下腔出血, 脑循环动力学

Abstract: ObjectiveTo to evaluate the effects of nimodipine on cerebrovascular function in subarachnoid hemorrhage(SAH) using cerebrovascular hemodynamic indexes (CVAI),and to study the clinical value of CVAI in the dosing of nimodipine after SAH.Methods58 patients with SAH were given nimodipine 0.25 μg/kg·min by intravenous drip(i.v) after admitted to hospital. CVAI and NIHSS were examind before and 1 d, 7 d, 14 d after intravenous. ResultsNimodipine improved cerebrovascular function significantly, including increasing cerebral blood velocity and flow, decreasing cerebrovascular resistance(R) and critical pressure(CP). For those patients with NIHSS worse and R value increased, increased dosing could decrease cerebrovascular resistance(P<0.05) and improve neurological function significantly(P<0.05). ConclusionIndividualization is necessary in dosing of nimodipine treatment of SAH. R value is a important index in adjusting the dose of nimodipine.

Key words: nimodipine, subarachnoid hemorrhage, cerebrovascular hemodynamics