摘要
背景:尼莫地平作为钙离子拮抗剂已广泛用于蛛网膜下腔出血,但对高血压脑出血患者神经功能及生活能力改善的作用以及对神经元特异性烯醇化酶(neuron-spicificenolase,NSE)的影响客观研究不足。目的:观察高血压脑出血患者使用尼莫地平后患者神经功能及生活能力的恢复以及对血浆NSE的影响。设计:随机对照试验研究。单位:四川省人民医院神经内科。对象:1997-10/1999-03住四川省人民医院神经内科的85例高血压脑出血患者,入院时发病时间不超过24h,经头颅CT证实为脑实质出血,血肿均小于40mL。患肿瘤、原发性脑室出血、继发性蛛网膜下腔出血、混合性脑卒中或其他神经系统疾病的患者排除在外。方法:85例高血压脑出血患者随机分为对照组和尼莫地平治疗组,动态观察患者神经功能缺损程度和总的生活能力评分,血浆NSE水平及血肿体积。主要观察指标:两组患者神经功能缺损程度;总的生活能力评分;血浆NSE水平。结果:尼莫地平治疗组与对照组的临床神经功能缺损程度及生活能力评分在病程第14天时差异无显著性意义(P>0.05),在第30,90天时治疗组的神经功能(77.91±42.46,85.03±45.95)。恢复优于对照组(65.21±35.74,73.02±40.12),差异有显著性意义,两组患者的血浆NSE水平在各个时间点上差异无显著性意义(P>0.05)。
BACKGROUND:Nimodipine has been widely applied in subarachnoid hemorrhage(SAH) as calcium antagonist;however,there is insufficient objective research regarding its impact on the improvement of nervous function and the ability of daily life (ADL),and neuron specific enolase(NSE) in patients with hypertensive cerebral h emorrhage. OBJECTIVE:To observe the improvement of nervous function and ADL in patients w ith hypertensive cerebral hemorrhage after the application of Nimodipine, as wel l as its impacts on plasma NSE. DESIGN:A randomized and controlled trial. SETTING:Department of Neurology,People's Hospital,Sichuan Province. PARTICIPANTS:A total of 85 patients with hypertensive cerebral hemorrhage with less than 24 hours of attack on admission,who were proved by head CT with brain hemorrhage and the all of the hematomas were less than 40 mL,were selected from the admitted patients of the department of Neurology of the People's Hospital, Sichuan Province from October 1997 to March 1999.Patients with tumor, primary ve ntricle hemorrhage,secondary SAH,mixture cerebral apoplexy or other nervous syst em diseases were excluded. METHODS:A total of 85 patients were randomly divided into control group and ni modipine group to dynamically observe the nervous functional defects and total s cores of ADL,plasma NSE level and hematoma volume. MAIN OUTCOME MEASURES:Nervous functional defect,total scores of ADL, plasma NS E level in patients of both groups. RESULTS:There were no significant differences of the clinical nervous function al defect and the scores of ADL between nimodipine group and control group on th e 14th day of the disease(P >0.05). The nervous functional rehabilitation on the 30th and the 90th day of patients in Nimodipine group(77.91±42.46),(85.03±45. 95) were significantly better than(65.21±35.74),(73.02±40.12) of control group .There were no significant differences of serous NSE levels on every time point between the patients of two groups(P >0.05). CONCLUSION:The intravenous application of nimodipine in the acute phase of cer ebral hemorrhage might possibly improve the nervous function and ADL of the pati ents; however,plasma NSE level has certain limitations as an indicator for the e valuation of the therapeutic effectiveness of the medicine for the treatment of cerebral hemorrhage.
出处
《中国临床康复》
CSCD
北大核心
2005年第1期180-182,共3页
Chinese Journal of Clinical Rehabilitation
