急性脑梗死患者血压与神经功能缺损的相关性研究

The Blood Pressure and Neurological Function Defect Scale(NFD) in Patients of Acute Cerebral Infarction

目的 研究高血压脑梗死患者急性期血压与神经功能缺损 (NFD)的相关性。方法 1 50例发病 2 4小时内的急性脑梗死患者 ,根据神经功能缺损评分分为A组 (58例NFD≤ 1 5分 )、B组 (47例NFD :1 6～ 30分 )、C组 (45例NFD :31～ 45分 )共 3组。治疗前测量患者血压、检查脑电图 (EEG)、1 33Xe吸入法测定脑血流量 (CBF)。同期 60例健康人为对照组。结果 C组血压为 1 78± 1 5mmHg ,显著高于B组 (1 61± 8mmHg)和A组 (1 4 7± 6mmHg) ,t=7.1和1 3 .6 ,P <0 0 1 ;而C组大脑半球平均CBF为 46± 3ml/ 1 0 0g/min ,显著低于B组 (49± 4ml/ 1 0 0 g/min)和A组 (52± 4ml/ 1 0 0g/min) ,t=3 .5和 7.1 ,P <0 0 1 ;A、B、C组EEG异常率分别为 46 .7%、64 .2 %和 95 .7% ,C组与A、B组比较 ,χ2 =1 3 .66和 7.49,P <0 0 1和P <0 0 5 ;C组收缩压、舒张压与神经功能缺损评分呈正相关r=0 76和r =0 55 ,均P <0 0 1 ,与平均CBF呈负相关r=- 0 87和 - 0 71 ,均P <0 0 1 ;A、B组则呈相反的相关性。结论 重型脑梗死急性期血压升高有害 。

Objective To study the correlation between BP and neurological function defect scale in the patients with acute cerebral infarction. Methods One hundred fifty patients with acute cerebral infarction (from onset to admission<12 hr) and hypertension were divided into three groups (group A: 58 cases, NFD≤15; group B: 47 cases, NFD=16～30; group C: 45 cases, NFD=32～45) by neurological function defect scale. All patients were examined by electroencephalogram(EEG) and cerebral blood flow(CBF, 133 Xe inhalation method). 60 health persons were as control groups. Results Blood pressure was 178±15 mmHg in group C, it was higher than group B(161±8 mmHg, t =2.52, P <0 01) and group A(147±6 mmHg, t =2.19, P <0 05 ). CBF was 39.2±3.4 ml/100 g/min in group C, lower than group B(46.2±5.1, t =3.17, P <0 01) and group A(56.7±6.4, t =2.98, P <0 01);Abnormal rate of EEG wre 46.7%?64.2% and 95.7% in A?B and C group, a significance difference between C group and others two groups( vs A and group B, χ 2=13.66 and 7.49, P <0 01 and P <0 05). In group C the SBP and DBP were positively related to neurological function defect scale ( r =0 76 and 0 55, respectively. P <0 01), the abnormality rate of EEG( r =0 65 and 0 59, respectively. P <0 01) and negatively to the average CBF( r =-0 87 and 0 71, respectively, P <0 01). On the contrast to Group C, in the Group A and B, the SBP and DBP were negatively related to the NFD and the abnormality rate of EEG, but positively related to the average CBF. Conclusion While high blood pressure was harmful to the patients with severe cerebral infarction, it may have a protective effect on mild cerebral infarction.