尼莫地平治疗弥漫性轴索损伤60例临床疗效观察

NIMODIPINE TREATMENT IN PATIENTS WITH DIFFUSE AXONAL INJURY

目的 :明确早期应用尼莫地平对弥漫性轴索损伤 (DAI)的疗效和安全性。方法 :根据特征性的弥漫性轴索损伤 (DAI)影像学诊断标准 ,60名颅脑外伤患者被诊断为DAI而进入这项开放平行对照试验。结果 :研究证实 :尼莫地平治疗是安全的 ,患者的耐受性较好。外伤后 3月两组在优良效果上进行比较 ,尼莫地平组优于对照组 ,但无显著性差异。在Ⅲ级DAI患者亚组中 ,尼莫地平治疗DAI的显著有效性得到了体现 (P <0 0 5 )。经TCD检查发现在本组中脑血管痉挛的发生率较高 ( 4 0 % )。结论 :临床上早期应用尼莫地平对DAI是有价值的。在DAI的临床治疗中 。

Objective:To test the efficacy and safety of early intervention with nimodipine treatment in DAI patients Methods:Based on the characteristic radiological signs and criteria for diffuse axonal injury(DAI), 60 consecutive patients with the diagnosis of DAI were enrolled in this open, parallel and controlled study Results:Nimodipine proved to be safe and well tolerated. Nimodipine produced a better clinical result than placebo, but there was no statistically significant difference between the two groups on favorable outcome at 3 months after injury.A clinical significance was suggested by the analyses in the subgroup of clinical Grade Ⅲ DAI. With the of TCD sonography we found that there is a higher incidence of cerebral vasospasm in this series (40%). Conclusions:A clinically valuable benefit is possible with early treatment of nimodipine in DAI patients.However, the prevention of ischemic brain damage remains the important therapeutic target in clinical management of DAI.