西比灵对高血压脑出血患者脑缺血变化的影响

Study of the effect of sibelium on ischemic changes and transcranial doppler dynamic observation changes after hypertensive intracerebral hemorrhage

目的探讨西比灵对高血压脑出血(HICH)患者脑缺血变化的影响。方法 76例高血压脑出血患者随机分为干预组和对照组,通过经颅多普勒(TCD)检测大脑中动脉(MCA)、大脑前动脉(ACA)和大脑后动脉(PCA)的收缩峰流速(Vs)、平均流速(Vm)、舒张末期流速(Vd)等参数的变化;同时观察颅内血肿大小及周围水肿的变化。结果对照组脑出血后两侧各血管Vm均降低,但血肿侧较对侧更为显著;干预组显示,西比灵可使脑出血后血流动力学参数(Vm)的改变程度减轻,血肿及周围水肿面积较对照组显著减小(P<0.05)。结论西比灵能促进高血压脑出血的水肿和血肿吸收,改善脑水肿周围缺血状态,TCD可有效监测脑出血后脑局部缺血变化,以指导临床治疗。

Objective To explore the effect of sibelium on ischemic changes in acute hypertensive intracerebral hemorrhage （HICH）. Methods Seventy-six patients with acute HCH were divided into the intervention group and control group. The two groups were compared with the index of mean velocity of blood flow （Vm） of middle cerebral artery （MCA）,anterior cerebral artery （ACA） and posterior cerebral artery （PCA）. At the same time neurological function,the size of intracranial hematoma and surrounding edema changes were observed. Results In the control group,the Vm of all the arterys in both sides decreased, the hemorrhage side varied more obviously.The results showed sibelium could reduce the degree of hemo dynamic change （Vm）, reduced the hematoma and the surrounding area of edema significantly compared with control group （P 〈 0.05）. Conclusion Sibelium can lessen brain edema,improve cerebral circulation and the ischemic state around brain edema, and promote recovery of neurological function after acute HCH. TCD can effectively monitor ischemia changes in cerebral hemorrhage and guide clinical treatment.