早期强化降压对高血压脑出血患者血肿、炎症、神经功能的影响

Effects of early intensive antihypertensive therapy on mass,inflammation and neurological function of patients with hypertensive intracerebral hemorrhage

目的探讨早期强化降压对高血压脑出血患者血肿、炎症及神经功能的影响。方法采用随机数字法将余杭区第一人民医院2014年1月—2016年6月间收治的168例高血压脑出血患者随机分为2组,每组84例。对照组仅给予常规降压,给予静滴硝酸甘油,维持收缩压在160~180 mm Hg。观察组给予早期强化降压,静脉泵入硝酸甘油,维持收缩压在130~140 mm Hg。通过CT结果统计2组血肿量,用Elisa法测定2组患者血清炎症因子(TNF-α、IL-1β、IL-6)水平,并采用美国国立卫生研究院卒中量表(NIHSS)评价2组患者神经功能。对数据进行统计学分析,进而探讨早期强化降压对高血压脑出血患者肿块、炎症、神经功能的影响。结果治疗1 d时,观察组血肿量明显低于对照组(P<0.05),血肿扩大比例为8.3%,显著低于对照组的20.8%(P<0.05)。治疗14 d时,2组TNF-α、IL-1β、IL-6显著降低(P<0.05),且观察组TNF-α、IL-1β、IL-6明显低于对照组(P<0.05)。治疗14 d时,2组NIHSS显著降低(P<0.05),且观察组NIHSS明显低于对照组(P<0.05)。结论早期强化降压可有效改善脑出血患者血肿、炎症和神经功能,治疗效果满意。

Objective To investigate the effeets of early intensive antihypertensive therapy on mass, inflammation and neurological function of patients with hypertensive intrac.erebral hemorrhage. Methods One hundred and sixty-eight patients with cerebral hemorrhage admitted from January,2014 to June,2016 were randomly divided into two groups, with 84 cases in each group. Patients in control group were only given conventional treatment, by intravenous titration of Nitroglycerin to maintain systolic blood pressure from 160 to 180 mm Hg. Patients in observation group were given early enhanced treatment,by pumped Nitroglycerin to maintain systolic blood pressure from 130 to 140 mm Hg. The hematoma of two groups were measured by CT results, the inflammation levels （ TNF-α, IL-1β, IL-6 ） of two groups were detected by Elisa methods,and neurological function of two groups were measured by National Institutes of Health Stroke Scale （NIHSS）. The data were statistical analyzed to investigate the effects of early intensive antihypertensive therapy on mass, inflamma- tion and neurological function of patients with hypertensive intraeerebral hemorrhage. Results After 1 d treatment, the hematoma volume of observation group was significantly lower than that of control group（ P 〈 0.05 ）. The hematoma en- largement ratio of observation group was 8.3% ,which was significantly lower than that of control group （20.8%） （P 〈 O. 05）. After 14 d treatment, the TNF-α, IL-1β and IL-6 levels of two groups were significantly reduced（ P 〈 0. 05 ）, and the TNF-α, IL-1β and IL-6 levels of obsmwation group were significantly lower than those of control group（ P 〈 0.05 ）. After 14 d treatment, the NIHSS level of two groups were significantly reduced （P 〈 0.05 ） , and the N IHSS level of observation group were significantly lower than those of control group （ P 〈 0.05 ）. Conclusion Early intensive antihypertensive therapy could improve the hematoma, inflammation and neurological function of patients with cerebral hemorrhage, with satisfactory effects.