Pickard J D, Walker V, Vile J, Perry S, Smythe P J, Hunt R
J Neurol Neurosurg Psychiatry. 1987 Jun;50(6):727-31. doi: 10.1136/jnnp.50.6.727.
The calcium antagonist nimodipine blocks the effects of many vasoconstrictors of cerebrovascular smooth muscle and may reduce the incidence of delayed cerebral ischaemia following subarachnoid haemorrhage though not necessarily by inhibiting the development of angiographic cerebral vasospasm. Post-haemorrhagic CSF contains abnormally large quantities of various eicosanoids that partly reflect enhanced production by cerebral arteries. Does nimodipine affect this process? The extra-arterial and intra-arterial production of PG6 keto-F1 alpha, PGE2, PGF2 alpha and TXB2 were measured in perfused common carotid arteries taken from rabbits in which the arteries had been ensheathed by blood clot in vivo for 7 days. All rabbits were given the antifibrinolytic agent tranexamic acid to retard resolution of the clot, and half were given oral nimodipine (2 mg/kg/day) for 10 days. Nimodipine significantly reduced the extra-arterial production of TXB2 during the third and fourth hours of perfusion and, less consistently, the production of PGF2 alpha, PGE2 and PG6 keto-F1 alpha. Lutrol, the solvent for nimodipine, had no such effect.
钙拮抗剂尼莫地平可阻断多种脑血管平滑肌血管收缩剂的作用,可能会降低蛛网膜下腔出血后迟发性脑缺血的发生率,不过不一定是通过抑制血管造影显示的脑血管痉挛的发展来实现。出血后脑脊液中含有异常大量的各种类二十烷酸,这部分反映了脑动脉生成的增强。尼莫地平会影响这个过程吗?对取自家兔的灌注颈总动脉中PG6酮 - F1α、PGE2、PGF2α和TXB2的动脉外和动脉内生成进行了测量,这些家兔的动脉在体内已被血凝块包裹7天。所有家兔均给予抗纤维蛋白溶解剂氨甲环酸以延缓血凝块的溶解,其中一半家兔口服尼莫地平(2毫克/千克/天),持续10天。尼莫地平在灌注的第三和第四小时显著降低了动脉外TXB2的生成,对PGF2α、PGE2和PG6酮 - F1α生成的降低则不太稳定。尼莫地平的溶剂聚氧乙烯氢化蓖麻油没有这种作用。