脑梗死个体化高血压的调治

REGULATION OF HYPERTENSION IN PATIENTS WITH CEREBRAL INFARCTION

目的研究脑梗死高血压调治技术预防脑梗死再发的效果与安全性。方法初发脑梗死患者266例随机分为治疗组(个体化5个层次的目标血压)和对照组(目标血压18.7/12.0 kpa左右)各133例。治疗组实施5个方面个体化的最佳目标血压水平,保持长期持续性稳定;对照组实施的目标血压为18.7/12.0 kPa左右,2组基本二级预防措施一致,随访3年对2组的功能健康水平和终点事件进行评定。结果治疗组功能健康水平明显高于对照组(P<0.01);3年后治疗组脑梗死再发率和死亡率明显低于对照组(P<0.01),2组心肌梗死及脑出血发生率差异无统计学意义(P>,0.05)。结论本项技术对初发脑梗死二级预防疗效显著、可靠安全,明显降低脑梗死再发率和病死率,提高了患者的生活质量和健康水平。

Objective To study the effect and safety of regulating hypertension in the patients for preventing the recurrence of cerebral infarction. Methods A total of 266 patients with primary cerebral infarction were divided into the treatment group（individual five levels of target blood pressure） and control group（target blood pressure 18.7/12.0kPa）, 133 cases in each group. The five level best target blood pressure were administered in the treatment group in order to sustain long-term stable blood pressure. Target blood pressure was about 18.7/12.0 kPa in the control group, Baseline treating measures of secondary prevention were similar in the two groups. After 3 years follow-up, the endpoint events and function levels of the patients were evaluated respectively. Results The functional level was higher in the treatment group than in the control group（ P〈0.01）. The mortality and the rate of cerebal infarction recurrence was lower in the treatment group than in the control group after three years（ P 〈0.01）. There were no significant difference in the occurrence of myocardial infarction and cerebral hemorrhage between the two groups （P 〈 0.05）. Conclusion The regulating measure is a safe, reliable method for the secondary prevention of the patients with primary cerebral infarction, which can obviously decrease the recurrence and mortality of the patients with cerebral infarction and increase the quality of life and the health level.