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Hypertension:尼伐地平对阿尔茨海默病患者脑血流量的影响

2019-06-18 xing.T MedSci原创

总之,尼伐地平降低血压并增加海马中的CBF,而其他区域显示CBF稳定或非显著性的增加。这些发现不仅表明阿尔茨海默病患者保留的脑自动调节,而且还提示抗高血压治疗的有益脑血管效应。

在阿尔茨海默病的早期发生的包括脑血流量减少(CBF)在的脑血管改变可能加速疾病进展。近日,心血管权威杂志Hypertension上发表了一篇研究文章,这项随机、双盲、安慰剂对照研究调查了钙拮抗剂尼伐地平治疗6个月后如何影响轻度至中度阿尔茨海默病患者的CBF。

研究人员采用全脑灰质中的磁共振动脉自旋标记和先前定义的感兴趣区域(包括海马)测量CBF。随机分配了58名患者(每组29名),其中22名患者均没有磁共振排除标准,并且在6个月内服药。

这些患者的平均年龄为72.8±6.2岁,平均迷你精神状态检查为20.4±3.4。尼伐地平治疗可降低收缩压(Δ=-11.5 [95%CI为-19.7至-3.2] mmHg; P<0.01),而全脑灰质CBF保持稳定(Δ=5.4 [95%CI为-6.4至17.2] mL/100克/分钟; P=0.36)。海马中的CBF增加(左:Δ=24.4 [95%CI为4.3-44.5] mL/100克/分钟; P=0.02;右:Δ=20.1 [95%CI为-0.6至40.8] mL/100g/分钟; P=0.06)。后扣带皮层或其他感兴趣的区域的CBF没有显著变化(Δ=5.2 [95%CI为-16.5至27.0] mL/100g/min; P=0.63)。

总之,尼伐地平降低血压并增加海马中的CBF,而其他区域显示CBF稳定或非显著性的增加。这些发现不仅表明阿尔茨海默病患者保留的脑自动调节,而且还提示抗高血压治疗的有益脑血管效应。 

原始出处:

Daan L.K. de Jong.et al.Effects of Nilvadipine on Cerebral Blood Flow in Patients With Alzheimer Disease A Randomized Trial.Hypertension.2019.https://doi.org/10.1161/HYPERTENSIONAHA.119.12892

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    2020-01-05 feather89
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JAHA:尼伐地平降低轻度至中度阿尔茨海默病患者的血压但不会增加直立性低血压的患病率

由此可见,该研究表明开始低剂量的抗高血压治疗并不会显著增加轻度至中度阿尔茨海默病患者的OH风险。

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