摘要
目的:探讨尼莫地平联合抗栓药物治疗短暂性脑缺血发作(transient ischem ic attack,TIA)的临床疗效及作用机制。方法:选择84例TIA患者,随机分为治疗组和对照组各42例,治疗组采用尼莫地平静脉滴注加基础抗栓治疗,对照组采用基础抗栓治疗。观察两组临床疗效,检测用药前后经颅多普勒(TCD)舒张期最小血流速度(Vd)、收缩期峰值血流速度(Vp)、平均血流速度(Vm)及脉动指数(PI)和血液流变学的变化。结果:治疗组总有效率为95.2%,显著高于对照组81.0%(P<0.05)。治疗组中高血压组的总有效率为96.8%,高于非高血压组的总有效率90.9%,但差异无统计学意义(P>0.05)。TCD检查显示用药后治疗组高流速血管的Vd较对照组增高,Vp、Vm及PI较对照组减低,而低流速血管的Vd、Vp及Vm较对照组增高,PI较对照组减低(P<0.01)。用药后两组血液流变学指标无显著性差异(P>0.05)。结论:尼莫地平联合基础抗栓治疗TIA可进一步提高疗效,尤对血压增高型可能更有优势,其机制与尼莫地平能够改善TIA患者血管顺应性有关。
Objective：To investigate the effect and the mechanism of Nimodipine with anti-thrombus drugs on transient ischemic attack （TIA）. Methods：Eighty-four patients with TIA were randomly and equally divided into the treatment group（ Nimodipine and anti-thrombus drugs）and the control group（anti-thrombus drugs）. Total efficacy rates in the two groups and the efficacy rates in the hypertension and non-hypertension sub-groups o were studied. Data of TCD （Vd, Vp, Vm and PI）and hemorheology（ high-shear blood viscosity,low-shear blood viscosity, plasma viscosity and hematocrit）before and after the therapy were examined. Results：① Occurrences of TIA in the treatment group were effectively inhibited. Total efficacy rate in the treatment group was 95.2% ,which was higher than that in the control group（ 81.0% ,P 〈 0.05 ） ; Total efficacy rate in the hypertension sub-group was 96.8% ,which was higher than that in the non-hypertension sub-group （90. 9% ,P 〉 0.05 ）. ②After therapy, Vd of high blood flow vessels in the treatment group was higher,while Vp,Vm and PI were lower,than that in the control group;Vd,Vp and Vm of low blood flow vessels in the treatment group were higher, while PI was lower, than those in the control group（ P 〈 0.01 ）. ③There were no significant differences of all hemorheology data between the treatment and control groups（ P 〉 0.05 ）. Conclusion： Nimodipine can improve the efficacy of anti-thrombus drugs on TIA ; Nimodipine has more effective on TIA patients with hypertension. The mechanism may be that Nimodipine improve the compliance of abnormal cerebral vessels.
出处
《临床误诊误治》
2007年第5期9-11,共3页
Clinical Misdiagnosis & Mistherapy
关键词
脑缺血发作
短暂性
尼莫地平
治疗
Transient ischemic attack
Nimodipine
Transcranial doppler
Hemorheology
