尼莫地平对脑出血患者局部脑血流、脑水肿及不同时间用药临床变化的影响

摘要

目的　动态观察尼莫地平对高血压脑出血患者局部脑血流（rCBF）、脑水肿和不同时间用药临床变化的影响。方法　随机将108例高血压脑出血患者分为对照组和治疗组，并将治疗组再分为发病前12小时以内用药组和12小时以后用药组，行单光子发射断层扫描(SPECT)、临床疗效的动态观察；并随机从对照组和治疗组中分别抽出10例患者行SPECT、CT的动态观察。结果　治疗组rCBF、水肿带和临床疗效的改善显著优于对照组；12小时以内用药的临床疗效明显优于12小时以后用药。结论　早期使用尼莫地平对改善高血压脑出血后rCBF下降、提高临床疗效和减轻血肿周围水肿可能均有积极作用。%Objective　To observe dynamically the effect of nimodipine on regional cerebral blood flow (rCBF),brain edema and clinical change of dosage at the different time in the patients with hypertensive cerebral hemorrhage.Methods　108 patients with hypertensive cerebral hemorrhage were divided into the nimodipine treatment group and the controls randomly,and the treatment group was divided into the group of within 12 h with drug and the group of after 12 h with drug again. All patients were given by dynamic observation of SPECT and clinical curative effect;and they were done by dynamic observation of SPECT and CT taking randomly 10 patients out of the groups of control and treatment.Results　The improvement of rCBF,clinical curative effect and edema girdle in the treatment group was significantly better than the control group. Patients of within 12 h with drug also showed better outcome than the patients of after 12 h with drug on clinical curative effect.Conclusion　Early stage with nimodipine may be positive factor in the improvement of rCBF,clinical curative effect and lightening edema around the hematoma after hypertensive cerebral hemorrhage.