尼莫地平预防蛛网膜下腔出血后脑血管痉挛的机制及应用

Mechanism and Application of Nimodipine for Prevention of Cerebral Vasospasm after Subarachnoid Hemorrhage

摘要: 蛛网膜下腔出血是卒中引起猝死的最常见原因，许多患者在就医途中死亡，而入院前死亡率在3%~26%。近年，系统回顾数据显示全球自发性蛛网膜下腔出血的年发病率为(2~16)/100,000，而且SAH后脑血管痉挛的致死、致残率极高。尼莫地平被认为是目前降低蛛网膜下腔出血后延迟性脑血管痉挛相关疾患发病率和死亡率的最佳方法，并已被美国高血压学会等指南列为有效防治脑血管痉挛的药物。更加深入地了解尼莫地平在预防蛛网膜下腔出血后引发脑血管痉挛方面的作用机制，对于临床实践具有极高的参考价值。

Abstract: Subarachnoid hemorrhage is the most common cause of stroke-induced sudden death, with many patients dying on the way to the hospital, and pre-hospital mortality ranging from 3% to 26%. In recent years, systematic reviews of data have shown a global annual incidence of spontaneous sub-arachnoid hemorrhage of (2 to 16)/100,000 and a very high rate of death and disability from cere-bral vasospasm after SAH. Nimodipine is considered to be the best available method to reduce the morbidity and mortality associated with delayed cerebral vasospasm-related disorders after sub-arachnoid hemorrhage and has been classified as an effective drug against cerebral vasospasm in guidelines such as those of the American Society of Hypertension. A deeper understanding of the mechanism of action of nimodipine in the prevention of cerebral vasospasm triggered after sub-arachnoid hemorrhage is highly informative for clinical practice.