自发性脑出血急性期血流动力学变化与血压的相关性研究

A Correlative Study of Cerebral Hemodynamic Charge and Blood Pressure in Acute Spontaneous Intracerebral Hemorrhage

目的探讨自发性脑出血急性期血流动力学的动态变化规律以及与血压之间的相关性。方法对54例自发性脑出血患者,于入院第1、7、21d进行床旁经颅多普勒超声(TCD)检测,并与24h动态血压监测进行相关性分析。结果TCD异常以大脑前循环为主,主要表现为高阻力低流速的血流频谱,出血侧更明显,两侧血流明显不对称。连续TCD监测发现,降低的血流速度逐渐增高,同时增高的脉动指数(PI)则逐渐降低,至第21dTCD检测基本恢复正常。第1、7d24h平均收缩压与大脑中动脉平均血流速度呈负相关(P<0·05),与PI呈正相关(P<0·01)。结论TCD检查可用于脑出血患者急性期脑血流动力学的监测,并在降血压治疗时提供有用的参考信息。

Objective To investigate the cerebral hemodynamic abnormal patter and its regularity of dynamic charge, and the correlation with abnormality of blood pressure （Bp） on acute stage of spontaneous intracerebral hemorrhage （SICH） patients by transcranial Doppler （TCD）. Methods 54 patients with acute SICH were studied. All patients were dynamic evaluated by beside TCD and 24h ambulatory blood pressure monitoring （ABPM） on the 1st, 7th, 21st day. Results On the 1st day the TCD abnormity occurred mainly in the anterior circulation of cerebrum, which the cardinal manifestation was high - resistanee, low -flow velocity blood waveforrns, especially the bleeding side. And the bilateral cerebral blood flow were significantly asymmetrieal. Continuous TCD monitoring revealed that, the low velocity of the cerebral blood flow increased, meanwhile the high value of PI decreased gradually, the TCD monitoring was within the normal range three weeks after the atttack. The 24 - hour＇s mean systolic blood pressure had negative correlation with the mean cerebral velocities of middle cerebral arteries, positive correlation with the PI value. Conclusion The TCD examination can be used to monitor the cerebral hemodynamies of the patients suffering from intracerebral hemorrhage, and provide useful referenees to the antihypertension management.