脑梗死急性期合并心衰血压调控策略

目的探讨脑梗死急性期合并心衰血压调控的标准及方法。方法收集100例发病在24h内的急性脑梗死合并心力衰竭（心功能Ⅱ-Ⅳ级）的患者资料，并随机分为硝普钠治疗组和对照组。全部患者在入院时均进行美国国立卫生院神经功能缺损评分、TCD检查。两组患者的发病年龄、血压增高程度、神经功能缺损评分、TCD改变以及心衰程度差异无统计学意义（P〉0.05）。结果心功能Ⅱ级患者血压控制对心衰有益，但却严重影响脑血流灌注。与对照组相比脑血流动力学受损明显。心功能Ⅲ-Ⅳ级患者经合理控制血压，心功能改善后脑血流灌注较对照组有明显改善。结论脑梗死急性期合并心衰合理调控血压，无论对心功能的改善抑或脑血流动力学和神经系统临床症状的好转都是十分有益的。

The regulating blood pressure in the acute cerebral infarction with heart failure

Objective The purpose of the study was to investigate the standard and method of regula-ting blood pressure in the acute cerebral infarction with heart failure. Methods 100 patients who suffered from acute cerebral infarction with heart failure(heart function Ⅱ-Ⅳ grade)in 24 hours were divided randomly into Sodium Nitroprusside treatment group and control group. There was no significant difference about ages, blood pressure,neurologic impairment score and heart failure degree of the patients in two groups. Results Control-ling blood pressure of patients with heart function Ⅱ grade was benefit to heart failure ,but the perfusion of cere-bral blood flow was influenced seriously compared with control group. Reasonably controlling blood pressure of patients with heart function Ⅲ-Ⅳ grade could improve heart function,and the perfusion of cerebral blood flow could also be improved compared with control group. Conclusion Reasonably control blood pressure of patients with acute cerebral infarction with heart failure was benefit to heart function, cerebral hemodynamics and nerval function.