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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(07): 663-670
DOI: 10.1055/s-0042-1755301
Original Article

Efficacy of nimodipine in the treatment of subarachnoid hemorrhage: a meta-analysis

Eficácia da nimodipina no tratamento da hemorragia subaracnoidea: uma metanálise
Jianqiang Liu 
1   West Hospital of Zibo Central Hospital, Department of Neurology, Shandong, China.
,
Cuimei Sun 
1   West Hospital of Zibo Central Hospital, Department of Neurology, Shandong, China.
,
Ying Wang 
1   West Hospital of Zibo Central Hospital, Department of Neurology, Shandong, China.
,
Guangjun Nie 
1   West Hospital of Zibo Central Hospital, Department of Neurology, Shandong, China.
,
Qihao Dong 
1   West Hospital of Zibo Central Hospital, Department of Neurology, Shandong, China.
,
Jiebing You 
1   West Hospital of Zibo Central Hospital, Department of Neurology, Shandong, China.
,
Qiang Li 
1   West Hospital of Zibo Central Hospital, Department of Neurology, Shandong, China.
,
Mingyue Li 
2   Sun Yat-sen University, The Third Affilated Hospital, Department of Rehabilitation Medicine, Guangdong, China.
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Abstract

Background Subarachnoid hemorrhage (SAH) is an uncommon and serious subtype of stroke, which leads to the loss of the patient's ability to produce and live for many years.

Objective To investigate the clinical effect of nimodipine in the treatment of SAH.

Methods Electronic databases including China National Knowledge Infrastructure (CNKI), VIP, SinoMed, China Master's Theses Full-text Database (CMFD), China Doctoral Dissertations Full-text Database (CDFD), Cochrane Library, PubMed and Embase were searched from 2010 and 2021. All randomized controlled trials evaluating the efficacy of nimodipine in the treatment of SAH were included in our meta-analysis. The patients were divided into control group and treatment group. Meta-analysis was performed with Stata16.0 software.

Results A total of 10 studies were included. Compared with the control group, the treatment group had higher effective rate (OR = 3.21, 95% CI: 2.25, 4.58; p < 0.001), and lower incidence of adverse reactions (OR = 0.35, 95% CI: 0.19, 0.67; p = 0.001). Before treatment, no significant differences were identified in middle cerebral artery blood flow velocity and Glasgow coma scale (GCS) score between the two groups. However, after treatment, the middle cerebral artery blood flow velocity (SMD = −1.36, 95% CI: −2.28, −0.49; p = 0.002) and GCS score (SMD = 1.24, 95% CI: 0.58, 1.89; p < 0.001) in the treatment group were significantly better than those in the control group.

Conclusions Nimodipine is effective in the treatment of SAH, lowering incidence of adverse reactions and therefore improving the prognosis of patients.

Resumo

Antecedentes Hemorragia subaracnóidea (SAH) é um subtipo raro e grave de acidente vascular cerebral (AVC), o que leva à perda da capacidade do paciente de produzir e viver por muitos anos.

Objetivo Investigar o efeito clínico da nimodipina no tratamento da SAH.

Métodos As bases de dados eletrônicas, incluindo a China National Knowledge Infrastructure (CNKI), VIP, SinoMed, Masters Theses Full-text Database (CMFD), China Doctoral Dissertations Full-text Database (CDFD), Cochrane Library, PubMed e Embase foram pesquisadas no período de 2010 a 2021. Todos os ensaios controlados aleatorizados que avaliam a eficácia da nimodipina no tratamento da SAH foram incluídos na nossa meta-análise. Os pacientes foram divididos em grupo controle e grupo de tratamento. Meta-análise foi realizada com o software Stata 16.0.

Resultados Foram incluídos um total de dez estudos. Em comparação com o grupo controle, o grupo de tratamento tinha uma taxa mais elevada (OR = 3,21, 95% CI: 2,25, 4,58; p < 0,001), e menor incidência de reações adversas (OR = 0,35, 95% CI: 0,19, 0,67; p = 0,001). Antes do tratamento, não foram identificadas diferenças significativas na velocidade média do fluxo sanguíneo da artéria cerebral e na pontuação de Glasgow coma scale (GCS) entre os dois grupos. No entanto, após o tratamento, a velocidade média do fluxo sanguíneo da artéria cerebral (SMD = −1,36, 95% CI: −2,28, 0,49; p = 0,002) e a pontuação do GCS (SMD = 1,24, 95% CI: 0,58, 1,89; p < 0,001) no grupo de tratamento foram significativamente melhores do que os do grupo controle.

Conclusões A nimodipina é eficaz no tratamento da SAH, diminuindo a incidência de reações adversas e, consequentemente, melhorando o prognóstico dos doentes.

Keywords

Nimodipine - Subarachnoid Hemorrhage - Meta-Analysis - Treatment Outcome

Palavras-chave

Nimodipina - Hemorragia Subaracnóidea - Metanálise - Resultado do Tratamento

Authors' Contributions

JL, CS, YW, QL, ML: substantial contributions to the design and development of the study; GN, QD, JY: substantial contributions in the collection, analysis, and interpretation of data; QL, ML: substantial contributions in the writing of the article, and in its critical revision; All authors: substantial contributions in the approval of the final version. Jianqiang Liu, Cuimei Sun and Ying Wang contributed equally in this article.


Support

This research is supported by the Key Research and Development Plan of Zibo City (No. 2019ZC020001).




Publication History

Received: 13 July 2021

Accepted: 07 October 2021

Article published online:
29 September 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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