血压管理对高血压脑出血患者血肿周围水肿的影响

目的 探讨高血压脑出血急件期血压管理对血肿周围水肿的影响.方法 采用回顾性研究方法,对2005年6月-2007年12月期间高血压脑出血住院患者的年龄、天数、降压药、脱水药和血压等因素进行logistic回归分析.结果 多因素分析发现,氨氯地平(OR=0.208,95%CI0.063～0.684)和血管紧张素转换酶抑制药(OR=0.280,95%CI 0.085～0.920)均为血肿周围水肿的保护因素;病程天数10～20 d(OR=7.413,95%CI 1.362～40.360)、舒张压控制小良(OR=6.449,95%CI 1.011～41.145)均为血肿周围水肿的危险因素.结论 服用氨氯地平和血管紧张素转换酶抑制药能降低脑出血血肿周围水肿的风险,而舒张压控制不良和病程10～20 d为血肿周围水肿的危险因素.

Effect of blood pressure management on perihematomal edema in patients with hypertensive intracerebral hemorrhage

Objective To investigate the effect of blood pressure management on perihematomai edema in patients with acute hypertensive intracerebral hemorrhage. Methods The retrospective research method was used to conduct logistic regression analysis for the factors of age, number of days, antihypertensive drugs, dehydrating agents, and blood pressure in inpatients with hypertensive intracerebral hemorrhage from June 2005 to December 2007. Results Multivariate analysis found that both amlodipine (OR = 0. 208, 95% CI 0. 063-0. 684) and angiotensin-converting enzyme inhibitor (ACEI) (OR = 0. 280, 95% CI 0. 085-0. 920) were the protective factors for perihematomal edema; both the course of 10 to 20 days (OR =7.413, 95% CI 1. 362-40. 360) and poorly controlled diastolic blood pressure (OR = 6. 449, 95% CI 1. 011-41. 145) were the risk factors for perihematomal edema. Conclusions Amlodipine and ACEI may lower the risk of perihematomal edema in intracerebral hemorrhage, while the poorly controlled diastolic blood pressure and the course of 10 to 20 days are the risk factors for perihematomal edema.