血管紧张素转换酶抑制剂类药物对高血压病合并腔隙性脑梗死患者脑血管反应性的影响

目的 观察ACEI类药物对腔隙性脑梗死患者脑血管反应性(cerebral vascular reactivity,CVR)的影响及作用机制.方法 31例腔隙性脑梗死患者作为研究对象,37例年龄、性别匹配的单纯高血压病患者作为对照.所有被研究者以贝那普利干预3个月,并于干预治疗前、疗程结束后通过TCD以屏气试验方法检测血管反应性(P<0构.05).通过Pearson积差分析BHI改善与血压下降的相关性.结果 2组患者BHI值改善与血压降低程度无相关性(P>0.05),说明ACEI类药物对脑血液动力学的影响独立于其降压作用之外,ACEI类药物具有神经保护作用.结论 ACEI类药物对于腔隙性脑梗死患者的脑血管调节能力具有改善作用,且这种作用与其降压作用无关.

Effects of angiotensin converting enzyme inhibitors on cerebral vascular reactivity in patients with hypertension complicated by lacunar cerebral infarction

Objective To observe the effects of angiotensin converting enzyme inhibitors on cerebral vascular reactivity ( CVR ) in patients with hypertension complicated by lacunar cerebral infarction , and to explore its action mechanism.Methods Thirty-one patients with lacunar cerebral infarction were enrolled as observation group in the study , moreover , the other 31 patients with hypertension ( the same age and sex as those in observation group ) were served as control group.All the subjects were treated by benazepril for three months ,and the CVR of patients was detected by routine TCD and breath-holding test before and after treatment .Moreover the correlation between breath-holding index ( BHI) improvement and blood presure decrease was evaluated by means of Pearson product-moment analysis .Results There was no correlation between BHI improvement and blood presure decrease in both groups ( P <0.05),which suggested that the effects of ACEI drugs on brain haemodynamics were independent of antihypertensive effects , moreover, ACEI drugs had neuroprotection effects.Conclusion ACEI drugs can improve cerebral vascular regulation ability in patients with lacunar cerebral infarction , moreover , the action is not related with its antihypertensive effects .