早期强化降压治疗与高血压脑出血血肿、血肿周围水肿的关系

Relationship between early intensively antihypertensive therapy and hematoma,perihermatomal brain edema of hypertensive intracerebral hemorrhage

目的探讨早期强化降压治疗与高血压脑出血(HICH)血肿、血肿周围水肿的关系。方法将50例HICH患者随机分为强化降压组(23例)及对照组(27例)。所有患者采用常规治疗,强化降压组患者加用氨氯地平10 mg/d。入院时及入院24 h后各进行一次头颅CT检查,比较两组的血肿及血肿周围水肿体积。结果入院时强化降压组及对照组SBP、血肿体积及周围水肿体积差异均无统计学意义(均P>0.05)。与对照组比较,强化降压组24 h SBP、血肿及血肿周围水肿体积显著缩小(均P<0.05)。Pearson相关分析显示,SBP与血肿、血肿周围水肿体积呈正相关(r=0.291,P=0.040;r=0.312,P=0.027)。结论早期强化降压治疗可减少血肿、血肿周围水肿体积。

Objective To explore the relationship between early intensively antihypertensive therapy and hematoma, perihermatomal brain edema of hypertensive intracerebral hemorrhage （ HICH ）. Methods Fifty HICH patients were randomly divided into intensively antihypertensive therapy group （23 cases ） and control group （27 cases）. All patients were given conventional treatment, and intensively antihypertensive therapy group was administrated with 10 mg amlodipine orally per clay additonally. Brain CT was performed at admission and 24 h later. Volume of hematoma and perihermatomal brain edema were compared between the two groups. Results The systolic pressure, volume of hematoma and perihermatoma] brain edema of intensively antihypertensive therapy group had no significant differences compared with the control group at admission （ all P 〉 0.05 ）. Compared with control group, systolic pressure, volume of hematoma andperihermatomal brain edema of intensively antihypertensive therapy group were significantly lower at 24 h after admission （ all P 〈 0.05 ）. Pearson correlation analysis showed a positive correlation between SBP and volume of hematoma, perihermatomal brain edema （ r = 0. 291, P = 0. 040; r = 0. 312, P = 0. 027 ）. Conclusion Early intensively antihypertensive therapy can reduce the volume of hematoma and perihermatomal brain edema of HICH.