脑梗死急性期不同级别血压对脑血流动力学的影响

The effect of different levels of blood pressure on cerebral hemodynamics in acute cerebral infarction

目的:研究不同级别血压对脑梗死急性期患者脑血流动力学的影响并探讨其临床意义。方法:选取不同级别血压的急性脑梗死患者148例,根据血压水平分为低血压组A组(n=27),高血压组B(n=32)、C(n=54)、D(n=35)三组,E组(n=30)选取同期门诊体检患者30例作为正常对照组。采用经颅多普勒(TCD)超声检测各组患者大脑中动脉(MCA)、大脑前动脉(ACA)、椎动脉(VA)及基底动脉(BA)并记录。结果:A组与E组比较,VA、BA的PI值增高,差异具有统计学意义(P<0.05)。C组、D组与E组比较,MCA、BA的PI、RI值增高,Vm值减低,ACA的PI值增高,差异具有统计学意义(P<0.05)。结论:脑梗死急性期患者血压过低或过高均可对脑血管的血流动力产生影响,对于脑梗死急性期患者的血压控制应该实行个体化治疗,在急性脑梗死早期可以将血压控制在正常或轻度升高的范围。

Objective ： To study the changes of cerebral hemodynamics in patients with acute cerebral infarction with different levels of blood pressure and its clinical significance. Methods： 148 patients with different levels of blood pressure in acute cerebral infarction were selected. According to the classification of blood pressure, they were divided into low blood pressure group A （ n = 27 ）, hypertension group B （ n = 32）, C （ n = 54 ）, D （ n = 35 ）. At the same time, 30 patients in outpatient department for physical examination were selected as the control group E （n = 30）. TCD was used to detect cerebral artery vessel in each group, including MCA, ACA, VA, BA, and the dates were recorded. Results：Compared with group E, the dates of PI,RI of VA, BA increased in group A, and the difference was statistically significant （P 〈 0. 05）. Group E was compared with group C and group D. The dates of PI,RI of MCA, BA increased, and the dates of Vm decreased, while the dates of PI about ACA increased （ P 〈 0.05 ）. Conclusion ： Both low blood press and high blood press can make differences in acute stage of cerebral for infarction patients. So the blood pressure management of patients in＂ the stage of cerebral infarction should be implemented by individual treatment. In the early stage, the blood pressure can be controlled in normal or slightly elevated range.