Nimodipine及其用于脑血管疾病:证据从最近的临床前和临床研究控制。

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Tomassoni D, Lanari Silvestrelli G, Traini E, Amenta F

Nimodipine及其用于脑血管疾病:证据从最近的临床前和临床研究控制。

Exp Hypertens。2008; 11月30 (8):744 - 66。doi: 10.1080 / 10641960802580232。

PubMed ID

19021025 (在PubMed

]

文摘

Nimodipine是1,4-dihydropyridine-derivative Ca(2 +)声道输出拦截器开发大约30年前。它是高度亲脂性的,穿过血脑屏障,到达大脑和脑脊液。早期治疗与nimodipine减少神经赤字造成的严重性蛛网膜下腔出血(SAH)患者的血管痉挛。在SAH, nimodipine spasm-related减少赤字的清规戒律,但没有spasm-unrelated赤字。本文综述了临床前研究的影响nimodipine各脑缺血的动物模型,特别注意对调查发表在过去十年。这些研究进一步支持nimodipine的主要标志,通过澄清一些anti-ischemic活动机制的化合物。报纸报道的可能角色nimodipine epileptogenesis也检查了。临床研究nimodipine分为蛛网膜下腔出血,急性缺血性中风,脑缺血没有中风、痴呆疾病,和偏头痛。临床调查表明,这种药物可以提高神经系统的结果通过减少缺血性赤字的发生率和严重程度的SAH患者颅内贝瑞动脉瘤破裂无论post-ictus神经病学方面的疾病。没有报道有关影响nimodipine治疗对于急性缺血性中风,脑缺血中风,比丛集性头痛和偏头痛,除了。 The less pronounced cardiovascular effects of nimodipine compared to other dihydropyridine-type Ca(2+)-channel blockers probably accounts for its use out of label for treating patients affected by chronic cerebral ischemia and vascular cognitive impairment. However, the blood pressure-lowering effects of nimodipine should not be minimized, as clinical studies have documented lowering blood pressure in small groups of patients, including cases of withdrawn due to pronounced hypotension induced by nimodipine administration. In the area of vascular cognitive impairment, short-term benefits of nimodipine do not justify its use as a long-term anti-dementia drug, and benefits obtained in elderly patients affected by subcortical vascular dementia require to be confirmed by other groups and in larger scale trials. In conclusion, nimodipine is a safe drug with an important place in pharmacotherapy and with the main documentation for reduction in the severity of neurological deficits resulting from vasospasm in SAH patients.

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药物

Nimodipine