Fagan S C, Gengo F M, Bates V, Levine S R, Kinkel W R
College of Pharmacy, Wayne State University, Detroit, Michigan.
Stroke. 1988 Mar;19(3):401-2. doi: 10.1161/01.str.19.3.401.
Nimodipine is currently under investigation for the treatment of acute stroke. Although relatively specific for the cerebrovasculature, acute reductions in blood pressure after a dose may adversely affect neurologic outcome. We studied 29 consecutive acute ischemic stroke patients treated with placebo (n = 9) or either 120 (n = 10) or 240 (n = 10) mg/day of nimodipine. Blood pressure was recorded before and 30 and 60 minutes after a dose for the first 8 days. Ten neurologic physicians were asked to predict the treatment group (placebo or drug) of randomly selected patients based on blood pressure results. Only those patients on 240 mg/day of nimodipine had significant decreases in blood pressure after a dose (p less than 0.001); however, these were minimal (average 10 mm Hg systolic). Only 26 of 48 treatment predictions (54%) were correct. At the studied doses, nimodipine has a minimal effect on blood pressure in the acute stroke period.
尼莫地平目前正在进行治疗急性中风的研究。尽管它对脑血管系统有相对特异性，但给药后血压的急性降低可能会对神经学预后产生不利影响。我们研究了29例连续的急性缺血性中风患者，他们分别接受安慰剂治疗（n = 9）或每天120 mg（n = 10）或240 mg（n = 10）的尼莫地平治疗。在最初8天里，记录给药前以及给药后30分钟和60分钟的血压。10位神经科医生被要求根据血压结果预测随机选择患者的治疗组（安慰剂或药物）。只有那些每天服用240 mg尼莫地平的患者在给药后血压有显著下降（p小于0.001）；然而，下降幅度很小（平均收缩压下降10 mmHg）。48次治疗预测中只有26次（54%）正确。在所研究的剂量下，尼莫地平在急性中风期间对血压影响极小。
