升压疗法在大动脉狭窄所致内分水岭脑梗死的临床研究

目的对颅内外大动脉狭窄致内分水岭脑梗死患者进行扩容治疗,提高患者平均动脉压,观察对血流动力学的影响。方法入选43例大动脉狭窄所致内分水岭脑梗死患者,应用药物升高平均动脉血压,按升高平均动脉压幅度的不同,设立两组,A组：平均动脉压升高10%～15%;B组：平均动脉压升高15%以上。行MRA检查观察大血管狭窄状况,按狭窄责任大血管部位的不同,设立颈内动脉狭窄组及大脑中动脉狭窄组两个亚组。通过TCD检测两组患者治疗前后责任侧大脑中动脉血流速度改变,评估患者升压治疗前后血压变化与血流动力学之间的关系。结果 B组患者患侧大脑中动脉TCD测定脑血流速上升值较A组有统计学意义（P〈0.05）。结论扩容升压治疗可以明显改善分水岭脑梗死的血流动力学指标,从而改善患者预后。

Clinical Observation on Elevating Blood Pressure in Treatment of Internal Watershed Infarction Due to Large Cerebral Artery Stenosis

Objective To investigate the effect of elevating mean artery blood pressure on hemodynamics of patients（pts） with internal watershed infarction due to extra-and intra-large cerebral artery stenosis.Methods Forty-three pts with internal watershed infarction were divided into group A（increaseing blood pressure 10% to 15%） and group B（increaseing blood pressure more than 15%）.Blood velocity in ipsilateral middle cerebral artery was detected by transcranial Doppler pre-and post-treatment.Results There was significantly difference in blood velocity of ipsilateral middle cerebral artery between group B and group A（P0.05）.Conclusion Blood pressure increase may improve the hemodynamics of internal watershed infarction and improve the prognosis of internal watershed infarction,especially for pts with stroke resulted from internal carotid arteriosclerosis.