降压治疗对高血压脑出血患者局部脑血流量及预后的影响

目的探讨不同程度药物降压对高血压脑出血患者局部脑血流量及预后的影响。方法经头颅CT确诊的30例高血压脑出血患者,测得首次入院血压,根据MAP降低程度不同分为A组(<10%)、B组(10～20%)、C组(>20%),并分别于入院24h内、3～5d、12～15d行单光子发射断层扫描和临床疗效评定。结果(1)C组局部脑血流量下降比值在各期均明显高于A组、B组(P<0.05);(2)C组神经功能下降在各期均较A、B组明显(P<0.05);(3)A组在急性期发生HD或HR机会多于B、C组(P<0.05)。结论在高血压脑出血早期,当收缩压>185mmHg或舒张压>95mmHg时,MAP降低约15%较为安全,对患者局部脑血流量和预后影响较小。

The effect of drug depressurization on regional cerebal blood flow and prognosis in patients with hypertensive intracerebral hemorrhage(HICH)

Objective To investigate the effect of drug depressurization on regional cerebral blood flow(rCBF) and prognosis in patients with HICH.Methods Thirty patients with HICH diagnosed by CT were divided into group A,B and C by their first mean arterial pressure(MAP) reduced about <10%,10%-20%,and >20%,respectively.SPECT and curative effect were assessed in the three groups.Results (1)The rCBF decrease in group C was significantly higher than that in group A and group B(P<0.05).(2) The neurological function in group C was significantly absenter than that in group A and group B(P<0.05).(3) The occurrence rate of HD or HR in acute phase of HICH in group A was higher than that in group B and group C(P<0.05).Conclusions In early phase of HICH,when SBP>185 mm Hg or DBP>95 mm Hg,the best MAP reduction is about 15%.