丁咯地尔和尼莫地平治疗脑血管痉挛的比较

Buflomedil vs nimodipine in treating cerebrovascular spasm

目的 :评价丁咯地尔和尼莫地平对脑血管痉挛 (CVS)的疗效和血流动力学的影响。方法 :CVS病人 117例随机分成 2组 ,丁咯地尔组给丁咯地尔 150mg ,iv ,gtt ,qd× 7～ 10d后改 150mg ,po ,tid× 3wk ;尼莫地平组给尼莫地平 10mg ,iv ,gtt,qd× 7～ 10d后改 30mg ,po ,tid× 3wk ,治疗后检测血流动力学变化。结果 :对蛛网膜下腔出血所致的CVS ,尼莫地平组有效率为 94 % ,丁咯地尔组为69 % (P <0 .0 5) ;对脑血管舒、缩功能紊乱所致CVS的有效率丁咯地尔组为 93% ,尼莫地平组为 61%(P <0 .0 5)。结论 :2药对不同病因CVS效果不同 ,应根据不同病因选择不同药物 ,TCD可作为CVS治疗中判断疗效的常规检测手段。

AIM: To evaluate the therapeutic effects and the hemodynamics of buflomedil and nimodipine in cerebral vascular (CVS). METHODS: One hundred and seventeen patients diagnosed as CVS were divided randomly as buflomedil group and nimodipine group. Former group, buflomedil was given as 150 mg, iv gtt, qd×7-10 d, then 150 mg, po ,tid×3 wk, while later group, nimodipine was givens 10 mg, iv gtt, qd×7-10 d, then 30 mg, po ,tid×3 wk. The change of hemodynamics was observed after therapy. RESULTS: The effective rate of nimodipine on CVS from SAH was 94%. Whereas that of buflomedil was 69% ( P <0.05). The efficiency of buflomedil on CVS from disorder of cerebrovascular diastole and systole was 93%, while that of nimodipine was 61% ( P <0.05). CONCLUSION: These two drugs should be selected for different etiology according to the different efficiency with the two drugs on CVS. TCD test can be used as the routinely detective technique to analyze the therapeutic effects.