高血压性脑出血患者预后与心脏事件的关系

The relationship between cardiac event and prognosis of the cerebral hemorrhage patients with hypertension

目的探讨高血压性脑出血患者左室肥厚、舒张功能减退及心脏事件与病死率的关系。方法选择经CT确诊的85例脑出血患者,分成A组56例,合并高血压;B组29例,无高血压。2组均采用彩色多普勒超声心动图测定左室结构及心功能有关数据;记录脑疝、心脏事件及死亡例数,2组分析比较。结果A组左室肥厚及舒张功能减退显著高于B组(P<0.01),收缩功能减退较B组明显,但统计学处理差异不显著(P>0.05);A组心脏事件39例(39/56,69.6%),死亡18例,B组心脏事件仅5例(5/29,17.2%),死亡3例,2组比较差异极显著(P<0.001,P<0.01)。结论左室肥厚、左室舒张功能减退导致心脏事件增多,是高血压性脑出血患者预后严重的主要因素。

Objective To investigate the relationship between left ventricular hypertrophy（ LVH） ,the disorder of left ventricular diastolic function ,cardiac event and the rote of death in the cerebral hemorrhage patients with hypertension. Methods Eighty - five patients who were made = definite diagnosis of cerebral hemorrhage by CT were derided into two groups：group A ,56 patients combined with hypertension;group B ,29 patients without hypertension. Data concerned about left ventrieular structure and cardiac function were all provoded by multicolor Doppler ccheeardiography in the two groups. The cases involved cerehral herniation ,eardiac event and death were recorded. Then the results were compared and analyzed between the two groups. Results The degree of LVH and the decline of diastolic function were significantly higher in group A than that in group B （ P 〈 0. 01 ）. The decline of systolic function in group A was higher than that in group B,but without significance （P 〉 0. 05）. There were 39 patients with cardiac events （39/56,69.6 % ）and 18 eases of death in group A, but only 5 patients with cardiac events （ 5/29,17.2% ） and 2 case of death in group B. The difference was significant （ P 〈 0. 001 ,P 〈0. 01 ,respectively） between the two groups. Condustons The cases of cardiac events will increase as the degree of LVH and the disorder of left ventricular diastolic function become severe. They are the main risk factors leading to unfavorable prognosis of the cerebral hemorrhage patients with hypertension.