高血压性脑出血早期血肿扩大与血压变异性的关系

Relationship of hematoma enlargement with blood pressure variability early after hypertensive intracerebral hemorrhage

目的探讨高血压性脑出血早期血肿扩大与血压变异性(BPV)的关系。方法 2014年4月到2016年5月收治高血压性脑出血100例,入院后行24 h血压动态监测;根据CT检查结果将100例分为血肿扩大组(30例)和非血肿扩大组(70例);采用条件Logistic回归分析检验早期血肿扩大与BPV的关系。结果血肿扩大组最大收缩压(SBP)、平均SBP均明显高于非血肿扩大组(P<0.05),两组最大舒张压(DBP)、平均DBP、SBP标准差(SD)、DBP SD、SBP变异系数(CV)、DBP CV均无统计学差异(P>0.05);血肿扩大组血肿增大比例[(52.31±3.48)%]、血肿体积[(16.78±2.35)ml]均明显高于非血肿扩大组[分别为(23.18±2.89)%和(7.48±1.28)ml;P<0.05]。Logistic回归分析结果显示,最大SBP、平均SBP是血肿扩大的独立危险因素(P<0.05)。结论高血压性脑出血后24 h内血肿扩大与BPV无明显关系,而与SBP变化有关。

Objective To investigate the relationship of hematoma enlargement with blood pressure variability （BPV） early after hypertensive intracerebral hemorrhage （HICH）. Methods Of 100 patients with HICH treated in our hospital from April, 2014 to May, 2016, 30 had hematoma enlargement and 70 did not 24 hours after admission to hospital. Detection of ECG, drug therapy, 24 hours dynamic detection of blood pressure and quantitative determination of changes in the hematoma volume with CT were performed after the admission to hospital in all the patients. Results The dynamic detection of 24 hours blood pressure showed that the maximal systolic blood pressure （SBP） and mean SBP were significantly higher in the patients with hematoma enlargement than those in the patients without hematoma enlargement （P〈0.05）. There were no significant differences in the maximal and mean diastolic blood pressure （DBP）, SBP coefficient of variability （CV） and DBP CV between the hematoma enlargement and no hematoma enlargement groups （P〉0.05）. Logistic regression analysis showed that the independent risk factors for hematoma enlargement included the maximal and mean SBP （OR=1.388, OR=1.230, respectively; P〈0.05）. Conclusions The mean and maximal SBP are the independent risk factors for hematoma enlargement within 24 hours after the admission to hospital in the patients with HICH. There is no significant correlationship between BPV and hematoma enlargement.