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基于人体研究探讨长春西汀在脑血管疾病治疗中的作用

[The role of vinpocetine in the treatment of cerebrovascular diseases based in human studies].

作者信息

Bagoly Edit, Fehér Gergely, Szapáry László

机构信息

Pécsi Tudományegyetem, Altalános Orvostudományi Kar Neurológiai Klinika Pécs Rét u 2 7623.

出版信息

Orv Hetil. 2007 Jul 22;148(29):1353-8. doi: 10.1556/OH.2007.28115.

Abstract

INTRODUCTION

It shows the importance of cerebrovascular diseases that they are the third main cause of death exceeded only by coronary artery diseases and cancer. Cerebral ischemia leads to irreversible brain damage, thereby it is important to rescue the hypoperfused areas. Patients without stroke but with chronic cerebral hypoperfusion can also benefit from the increasing of the cerebral blood flow.

METHODS

The aim of this review was to summarize the indications and the potential effects of vinpocetine in acute and chronic cerebrovascular diseases based on clinical studies.

RESULTS

There is no evidence that vinpocetine treatment is applicable in acute ischemic stroke, only few study with low patient number showed a slight but significant improvement in the patients conditions. In chronic cerebrovascular patients after single dose and long-term vinpocetine therapy, PET, TCD, SPECT and NIRS examinations showed increasing perfusion and elevated glucose and O 2 consumption of the examined areas, furthermore significant improvement of the rheologic factors was detected. A meta-analysis of international clinical studies showed a significant improvement in cognitive achievement in chronic stroke patients after oral therapy.

CONCLUSION

The cited studies showed the potential multi-pharmacological effects of vinpocetine and its beneficial hemorheological potential. The drug also improves the blood flow and the metabolism of the affected brain areas. There is increasing evidence that vinpocetine improves the quality of life in chronic cerebrovascular patients.

摘要

引言

脑血管疾病是仅次于冠状动脉疾病和癌症的第三大主要死因,这表明了其重要性。脑缺血会导致不可逆的脑损伤,因此挽救灌注不足的区域很重要。没有中风但患有慢性脑灌注不足的患者也可以从增加脑血流量中获益。

方法

本综述的目的是基于临床研究总结长春西汀在急性和慢性脑血管疾病中的适应症及潜在作用。

结果

没有证据表明长春西汀治疗适用于急性缺血性中风,只有少数患者数量较少的研究显示患者状况有轻微但显著的改善。在慢性脑血管疾病患者中,单剂量和长期使用长春西汀治疗后,PET、TCD、SPECT和NIRS检查显示检查区域的灌注增加,葡萄糖和氧气消耗升高,此外还检测到血液流变学因素有显著改善。一项对国际临床研究的荟萃分析表明,口服治疗后慢性中风患者的认知成绩有显著改善。

结论

引用的研究显示了长春西汀潜在的多种药理作用及其有益的血液流变学潜力。该药物还能改善受影响脑区的血流和代谢。越来越多的证据表明长春西汀可改善慢性脑血管疾病患者的生活质量。

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