川东北地区脑出血患者急性期降压治疗现状调查研究

Present investigation on antihypertensive therapy in patients with acute cerebral hemorrhage in Northeast Sichuan

目的观察川东北地区高血压脑出血患者急性期降压治疗现状及其对院内病死率的影响。方法回顾性抽样2011-01—12在川东北地区部分医院住院发病24h内高血压脑出血患者,了解急性期降压治疗现状,降压治疗对脑出血患者院内病死率的影响。结果抽样调查起病24h内脑出血患者876例,血压升高者比例占93.2%,急性期内启动降压治疗率68.6%,超早期启动静脉降压13.2%。3级血压水平患者降压组病死率低于非降压组(P<0.05),其中静脉降压组显著低于非静脉降压组(P<0.01);启动降压≤24h和>24h院内病死率亦差异有统计学意义(P<0.05)。结论脑出血患者早期血压升高明显;川东北地区多数脑出血患者在急性期内启动降压治疗;降压治疗尤其合并超早期静脉降压可以降低3级血压水平患者的院内病死率。

Objective To observe the current situation of antihypertensive therapy in patients with acute hypertensive cerebral hemorrhage in Northeast Sichuan and to explore its influence on in-hospital mortality. Methods We retrospectively sampled patients of hypertensive cerebral hemorrhage within 24 hours of onset in part of the hospitals of Northeast Sichuan ar- ea from January 2011 to December 2011 and analyzed current status of antihypertensive treatment at acute phase and the effect of antihypertensive therapy on in-hospital mortality. Results Of 876 cases with cerebral hemorrhage sampled, the ratio of hy- pertension accounted for 93.2%, and rate of initiating antihypertensive treatment occupied 68.6% and ratio of the activation of intravenous antihypertensive therapy at super-early stage was 13.2 %. Patients with stage 3 hypertension treated by antihyper- tensive treatment had lower in-hospital mortality compared with patients by non-antihypertensive treatment（P〈0.05）. Addi- tionally, patients treated by intravenous antihypertensive therapy held remarkably statistical difference relative to those by non -intravenous antihypertensive therapy（P〈0.01）. And the time of 24 hours or less to antihypertensive activation had lower mortality compared with the time of more than 24 hours （P〈0.05）. Conclusion Patients with cerebral hemorrhage are often concomitant with hypertension, and majority of acute stoke patients are treated by early antihypertensive therapy. Moreover, antihypertensive treatment particularly combined by intravenous antihypertensive therapy can beneficially reduce the in-hospital mortality.