控制血压防止高血压脑出血血肿扩大的研究

Investigation of blood pressure control to prevent hypertensive cerebral hemorrhage with hematoma enlargement

目的研究控制血压对防止高血压脑出血血肿扩大的效果。方法将96例病程<3h,平均动脉压(MAP)>130mmHg(1mmHg=0.133kPa)的高血压脑出血患者随机分为治疗组(48例)和对照组(48例);治疗组采用舌下含服卡托普利12.5～25mg,每3～4h1次,使MAP≤130mmHg并维持到病后24h,对照组不用任何降压药物,观察并比较两组血肿扩大的发生率。结果治疗组患者舌下含服卡托普利后15min起效,60min时MAP均降至≤130mmHg,并维持稳定,与对照组比较差异有显著性(P<0.05～0.01)。治疗组血肿扩大的发生率8.3%,对照组22.9%,两组比较差异有显著性(P<0.01)。结论舌下含服卡托普利控制高血压脑出血患者发病后24h内的血压可防止其血肿扩大,舌下含服卡托普利安全有效。

Objective Investigate the effect on blood pressure （BP）control to prevent hypertensive cerebral hemorrhage with hematoma enlargement. Methods 96 patients with hypertensive brain hemorrhage in course of disease less than 3 hours and mean arterial pressure （MAP） more than 130 mmHg （ 1 mmHg = 0. 133 kPa） were divided into randomly treatment group（48 cases ） and control group（48 eases）. The patients in treatment group were administered 12. 5- 25 mg Captopril sublingually per 3 -4 h to control MPA ≤ 130 mmHg and keep 24 hours since disease onset. However, the patients in control group were disused any hypotensive drug. Two groups were compared with the incidence rate of enlarged hematoma. Results Captopril sublingually had its effect after 15 minutes administered, and MPA was controlled ≤ 130 mmHg during 60 minutes administered and keep well. The difference between two groups was statistically significant. The enlarged hematoma incidence rate of treatment group was 8.3% and that of the control group was 22.9%. The difference between two groups was significant （ P 〈 0.01 ）. Conclusion Captopril sublingually controlling BP of patients with hypertensive cerebral hemorrhage can prevent from their hematoma enlargement. It is safe and effective way for Captopril sublingually.