尼莫地平对急性脑梗死的疗效时间及疗效评价

Treatment of acute cerebral infarction with intravenous nimodipine: evaluation of therapeutic time and effect

目的：探讨尼莫地平对急性缺血性脑梗死的最佳治疗时间及疗效。方法：将发病２ｗｋ内的急性脑梗死病人１６０例随机分为：尼莫地平组８０例（男性５４例，女性２６例；年龄６０±ｓ１０ａ）用尼莫地平４ｍｇ，ｉｖ，ｇｔ，ｑｄ×２ｗｋ。ｗｋ１，２同时用甘露醇、维生素Ｃ及吡硫醇；ｗｋ３，４应用羟乙基淀粉，阿司匹林及吡硫醇。对照组８０例（男性４７例，女性３３例；年龄５９±１２ａ）不用尼莫地平，其余同上。结果：尼莫地平组疗效均优于对照组（Ｐ＜０．０５或Ｐ＜０．０１）。发病２４和４８ｈ内疗效最佳，超过７２ｈ则无效。未发现明显不良反应。结论：尼莫地平治疗急性脑梗死应在２ｄ内。

AIM: To study the effective time of nimodipine in treating acute ischemic cerebral infarction. METHODS: One hundred and sixty patients with acute cerebral infarction within 2 wk were randomized divided into 2 groups: 80 patients (M 54, F 26; age 60±s 10 a) in treatment group received nimodipine 4 mg, iv, gtt, qd for 2 wk; Simultanneously received therapy including manntol, vitamin C, pyritinol in 1_2 wk; received therapy including hetastarch, aspirin, pyritinol in 3_4 wk. Control group 80 patients (M 47, F 33; age 59±12 a) received therapy except nimodipine and other therapy was the same as treatment group. RESULTS: The nerve functional defect scores of the treatment group decreased more than those of the control group at the end of the 4th wk (P<0.05). Nimodipine was most effective in patients with onset <24 or <48 h probable effective in patients onset <72 h, but no effective after 72 h. Marked adverse reactions were not seen. CONCLUSION: Intravenous nimodipine was effective in the treatment of acute cerebral infarction within 2 d.