急性脑出血患者早期强化降血压治疗的疗效及安全性研究

Effect and Safety of Early Intensive Blood Pressure Reduction in Patients with Acute Cerebral Hemorrhage

目的评价急性脑出血患者早期强化降血压治疗的疗效及安全性。方法符合条件的脑出血患者106例随机分为两组,即降压组和传统组,传统组按传统指南降压;降压组则对高于标准血压者均予降压治疗,目标血压为140/90mm Hg。分别在发病后24h、7d比较两组血肿增大情况,及3月时比较疾病转归情况(死亡率、神经功能缺损评分、并发症)。结果脑出血后24h,两组患者脑血肿大小平均值无显著差异(P>0.05),两组血肿增大平均值和增大比例分别为2.30ml、15.73%和7.76ml、39.06%,差异均有统计学意义(P<0.01);脑出血后7d,两组患者脑血肿大小平均值、血肿增大平均值和增大比例均无显著差异(P>0.05);3月时,两组患者在死亡率、神经功能缺损评分和并发症等方面,差异无统计学意义(P>0.05)。结论急性脑出血早期强化降压有利于减少血肿增大,而且安全。

Objective To evaluate the efficacy and safety of intensive blood pressure（BP） reduction in patients with acute cerebral hemorrhage.Methods A total of 106 patients with acute cerebral hemorrhage were randomly divided into blood pressure reduction group and traditional group.Patients in traditional group were treated traditional guideline-based management of BP,and Patients in blood pressure reduction group were treated to early intensive lowering of BP（140/90mm Hg）.After 24 hours,7 days,Comparison of two groups were made in enlargement of hematoma volume,and compared with clinical outcomes（mortality,neurological functional deficit scales,complications） after 3 months.Results After 24 hours,there were no significant difference（P〉0.05） in average hematoma volume between two groups,and the enlarged volume and percentage of hematoma were 2.30ml,7.76ml and 15.73%,39.06%,the difference were significant（P〈0.01）.There were no significant difference（P〈0.05） in average volume,enlarged volume and percentage of hematoma after 7 days.And after 3 months,There were also no significant difference（P〉0.05） in clinical outcomes.Conclusion Early intensive BP-lowering treatment can reduce haematoma growth in acute cerebral hemorrhage,and safe.