尼莫地平改善椎基底动脉供血不足患者的效果:随机分组对比

Effect of nimotop on patients with vertebrobasilar insufficiency: Randomized grouping comparison

目的:观察尼莫地平对椎基动脉供血不足患者临床症状及血浆内皮素1,血栓素A2和前列腺环素的影响。方法:选择2004-01/2005-12郧阳医学院附属人民医院神经内科收治椎基底动脉供血不足患者70例,随机分为治疗组32例,对照组38例。治疗组:尼莫地平注射液(0.2g/L)用微量泵静脉泵入,起始剂量为1mL/h,随后根据血压情况可逐渐递增至5mL/h。每日维持时间不少于12h,连用1周后,改口服尼莫地平片30mg,3次/d,连用1周。对照组:低分子右旋糖苷500mL+胞磷胆碱0.75g,静脉滴注,连用15d。治疗前后采集静脉血,放射免疫法测定内皮素1、血栓素B2和6-酮前列腺素F1α。治疗前后经颅多普勒超声观察颅内血管情况,脑干听觉诱发电位观察脑干缺血情况。结果:纳入患者70例,均进入结果分析。①治疗前后血浆内皮素1,血栓素B2和6-酮前列腺素F1α的变化:治疗前治疗组血浆中内皮素1,血栓素B2和6-酮前列腺素F1α与对照组相比差异无显著性(P>0.05)。治疗后治疗组血浆中内皮素1和血栓素B2的含量下降,与治疗前相比差异显著(P<0.05)。而对照组内皮素1,血栓素B2和6-酮前列腺素F1α的变化均不显著(P>0.05)。②治疗前后两组经颅多普勒超声和脑干听觉诱发电位异常率:两组治疗前相比差异无显著性(P>0.05),治疗后两组相比差异非常显著(P<0.01)。③两组疗效比较:治疗组与对照组比较差异显著(P<0.01),治疗组疗效明显优于对照组。结论:尼莫地平对椎基底动脉供血不足患者血浆内皮素1,血栓素A2和前列腺环素具有明显的影响,疗效肯定,副作用小。

AIM： To study the effect of nimotop on clinical manifestation,endothelin-1 （ET-1）, thrombexaneA2 （TXA2） and prostacyclin （PGI2） in plasma of the patients with vertebrobasilar insufficiency. METHODS： Totally 70 patients with vertebrobasilar insufficiency treated in Department of Neurology, the People＇s Hospital, Affiliated to Yunyang Medical College between January 2004 and December 2005 were randomly divided into two groups： experimental group （n=32） and control group （n=38）. Treatment group： nimotop injection （0.2 g/L） was given by micro pump intravenously with the initial velocity of 1 mL per hour, and increased gradually to 5 mL per hour according to blood pressure. After a one-week injection of over 12 hours a day, 30 mg nimotop tablet was taken orally three times a day for a week. Control group： 500 mL low molecular dextran and 0,75 g citicoline were injected intravenously, once a day and continuously for 15 days, Before and after treatment, venous blood were taken respectively so as to measure the ET-1,thromboxane B2（TXB2） and 6- keto-prostaglandin F1α（6-keto-PGF1α） with radioimmunoassay method. The blood vessels in brain were observed by transcranial Doppler ultrasound （TCD） before and after treatment. The ischemia status of brain stem was observed by brainstem auditory evoked potential （BAEP）. RESULTS： All 70 patients were involved in the result analysis. ①The change of ET-1, TXB： and 6-keto-PGF1α before and after treatment： Before treatment, there was no difference of ET-1, TXB2 and 6-keto-PGF1α between experimental group and control group（P 〉 0.05）.After treatment, the contents of ET-1, TXB2 decreased, and there was significant difference compared with that before treatment （P 〈 0.05）. No remarkable change was found in ET-1, TXB2 and 6-keto-PGF1α of control group （P 〉 0.05）.②The abnormal rate of TCD and BAEP in 2 groups before and after treatment： No significant difference was found between 2 groups before treatment （P 〉 0.05）, while difference was significant after treatment （P 〈 0.01）.③The effect comparison between 2 groups： The curative effect was notably better in experimental group than in control group with the significant difference （P 〈 0,01）. CONCLUSION： Nimotop has the obvious impact on ET-1, TXA： and PGI2 of patients with vertebrobasilar insufficiency with the safe effect and its side effect is mild.