尼群地平对动脉瘤性蛛网膜下腔出血患者脑血流和脑代谢的影响

Effects of Nitrendipine on Cerebral Blood Flow and Cerebral Metabolism in Patients with Aneurysmal Subarachnoid Hemorrhage

目的:观察尼群地平对动脉瘤性蛛网膜下腔出血(SAH)患者的脑血流和脑代谢的影响。方法:选择100例SAH患者,所有患者均采用口服尼群地平常规治疗,并进行综合检测。观察治疗前后患者的平均动脉压(MAP)、脑灌注压(CPP)、颅内压(ICP)、氧分压[pbt(O2)]和脑血流量(CBF)的变化。结果:治疗后,患者的MAP较治疗前平均降低1.33mmHg,CPP平均降低1.22mmHg,pbt(O2)平均降低了0.2mmHg,均较治疗前显著改善,差异有统计学意义(P<0.05)。尼群地平治疗与患者的自身调节失常指数以及代谢障碍指数无临床显著相关性。结论:口服尼群地平可以降低动脉瘤性SAH患者的MAP,改善患者的CBF和pbt(O2),且不会引起明显的自身调节失常和代谢障碍。

OBJECTIVE：To observe the effects of oral dose of nimodipine on cerebral blood flow and cerebral metabolism in patients with aneurysmal subarachnoid hemorrhage（SAH）.METHODS：100 SAH patients were included and received conventional treatment of nimodipine and comprehensive examination.Changes in physiologic measurements including MAP,CPP,ICP,pbt（O2）,and CBF were examined before and after treatment.RESULTS：After treatment,MAP of patients decreased by 1.33 mmHg and CPP by 1.22 mm Hg and pbt（O2）by 0.2 mm Hg.They were improved significantly;there was statistical significance（P0.05）.There was no clinical significant correlation of nitrendipine treatment with self-regulation disorder index and metabolic disturbance index.CONCLUSION：Oral dose of nitrendipine can reduce MAP and improve CBF and pbt（O2）of the patients with aneurysmal subarachnoid hemorrhage.It will not cause significant disorders of self-regulation and metabolic disorder.