Efficacy And Safety Of Nimodipine In The Treatment Of Cerebral Vasospasm After Spontaneous Subarachnoid Hemorrhage

Objective:1. The literature review, analyze and summarize the mechanism of cerebral vasospasm (CVS)from spontaneous subarachnoid hemorrhage, as well as the therapeutic mechanism ofnimodipine, clinical and prospects for development.2. Randomized controlled pilot study for meta-analysis on efficacy and safety of nimodipinetreatment of CVS,and clinical evidence.Methods:Access to literature, data entry and index analysis, to inspection a bias.Results:1. A cerebral vasospasm (CVS) from spontaneous subarachnoid hemorrhage caused by spasmfactors: In the traditional areas including the release of vascular endothelial vasomotor factorimbalance, inflammation, vascular cell wall proliferation, apoptosis, blood hypercoagulability,and platelet aggregation; the field of molecular biology and gene expression and signaltransduction. The mechanism of cerebral vasospasm, whether it is the imbalance of vasomotorfactors, the vessel wall structural changes, inflammatory response, or signal transduction bymolecular biology, are closely related to Ca2+.2. Nimodipine mainly through L-type calcium channel blockade, inhibition of extracellular Ca2+influx, and Ca2+in vascular smooth muscle cells to reduce alleviate cerebral vasospasm, andprotect neurons. In the clinical are diverse, safe and effective.3. Included in the23studies, testing heterogeneity, fixed effects model merge, Meta-analysis ofnimodipine group reduced the number of the occurrence of cerebral vasospasm, does not causean increase in the number of rebleeding, the death rate is lower than the control group.4Funnel plot, Begg method and Egger assay both showed no obvious bias in the study. Conclusion:1The mechanism of cerebral vasospasm is in mainly dependent adjustment, supplemented bynon-calcium ions in dependent adjustment, the calcium ions concentration changes in regulationof cerebral vascular smooth muscle contraction and relaxation; traditional and molecular biologystudies have shown that of calcium ions is caused by brain vascular spasm elements. Formechanism of cerebral vasospasm research can provide more treatment.2Nimodipine and cerebrovascular receptor with high affinity, mainly to block L-type calciumchannels, combined with specific receptors, regulate the calcium ions concentration, cellprotection, and inhibition of vascular smooth muscle contraction to relieve vasospasm. Extensiveclinical of nimodipine, it is a classic drug for the treatment of cerebral vasospasm use methodswith advances in technology improve.3.meta-analysis of the efficacy of nimodipine in the treatment of cerebral vasospasm better thanthe control group, it can reduce the number of deaths, without increasing the risk of rebleeding,nimodipine in the treatment of subarachnoid hemorrhage, cerebral vasospasm safe and effective.4Without gold standard of bias, the software has its limitations, does not rule out the existenceof bias in the results.