丁苯酞对高血压脑出血患者血肿周围水肿及动态血压的影响

Effects of butylphthalide on edema around hematoma and ambulatory blood pressure in hypertensive intracerebral hemorrhage

目的 分析丁苯酞对高血压脑出血患者血肿周围水肿及动态血压的影响.方法 收集2014年12月至2016年2月深圳市龙华区人民医院收治的92例高血压脑出血患者的临床资料,依据抽签法随机分为对照组和研究组,每组各46例,对照组予以常规治疗,研究组在常规治疗基础上加用200 mg丁苯酞胶囊口服,3次/d,20 d为1个疗程.比较两组患者血肿及周围水肿、动态血压的变化,观察两组患者的临床疗效及不良反应.结果 治疗前,两组患者血肿体积、水肿体积及血压比较差异均无统计学意义（P均〉0.05）.治疗后,研究组血肿体积、水肿体积、24 h平均收缩压、24 h平均舒张压、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压均低于对照组[血肿体积：（7.54±1.36）ml与（10.63±2.59）ml,水肿体积：（4.59±1.35）ml与（7.36±2.14）ml,24 h平均收缩压：（125.49±6.34）mmHg与（133.48±7.11）mmHg,24 h平均舒张压：（83.42±5.10）mmHg与（87.61±5.73）mmHg,日间平均收缩压：（127.83±9.51）mmHg与（138.29±10.21）mmHg,日间平均舒张压：（85.36±6.11）mmHg与（89.51±6.34）mmHg,夜间平均收缩压：（124.60±7.31）mmHg与（135.39±7.85）mmHg,夜间平均舒张压：（82.24±5.14）mmHg与（87.53±5.70）mmHg],两组比较差异均有统计学意义（t值分别为20.691、28.816、5.689、3.705、5.085、3.197、6.823、4.675,P均〈0.05）;研究组有效率为91.30％（42/46）,对照组为73.91％（34/46）,两组比较差异有统计学意义（χ^2=4.842,P〈0.05）;两组患者不良反应发生率比较差异无统计学意义（P〉0.05）.结论 丁苯酞对高血压脑出血患者的治疗效果确切,可有效改善血肿周围水肿及动态血压.

Objective To analyze the effect of butylphthalide on edema around hematoma and ambulatory blood pressure in patients with hypertensive intracerebral hemorrhage. Methods From December 2014 to February 2014, ninety-two cases of hypertensive cerebral hemorrhage patients treated in People′s Hospital of Longhua, Shenzhen were selected, the patients were divided into the control group and the study group,each with 46 cases. The control group received routine treatment. The study group was given 200 mg butylphthalide Capsule on the basis of conventional treatment,3 times /d,and 20 d for 1 course. The hematoma and surrounding edema and the changes of ambulatory blood pressure were compared between the two groups. The clinical efficacy and adverse reactions of the two groups were observed. Results Before treatment, there was no significant difference in hematoma volume, edema volume and blood pressure between the two groups （ P〉0. 05） . After treatment,the hematoma volume,edema volume,24 h mean systolic pressure,24 h mean diastolic pressure,mean day systolic pressure,mean daytime diastolic pressure,mean night systolic pressure,and mean night diastolic pressure were lower than those of the control group（hematoma volume： （7. 54±1. 36） ml vs. （10. 63 ±2. 59） ml,edema volume： （4. 59±1. 35） ml vs. （7. 36±2. 14） ml,24 h mean systolic blood pressure：（125. 49±6. 34） mmHg vs. （133. 48±7. 11）mmHg,24 h mean diastolic pressure： （83. 42±5. 10） mmHg vs. （ 87. 61 ± 5. 73 ） mmHg, mean daytime systolic pressure： （ 127. 83 ± 9. 51 ） mmHg vs. （ 138. 29 ±10. 21） mmHg,daytime mean diastolic pressure：（85. 36±6. 11）mmHg vs. （89. 51±6. 34） mmHg,night mean systolic pressure： （ 124. 60 ± 7. 31 ） mmHg vs. （ 135. 39 ± 7. 85 mm ） mmHg, night mean diastolic pressure：（82. 24±5. 14） mmHg vs. （ 87. 53 ± 5. 70 mm） mmHg, the differences in the two groups were statistically significant （ t=20. 691,28. 816,5. 689,3. 705,5. 085,3. 197,6. 823,4. 675,P〈0. 05）; the effective rate of the study group was 91. 30% （ 42/46） ,and the control group was 73. 91% （ 34/46） ,and the difference between the two groups was statistically significant （χ^2 = 4. 842, P〈0. 05 ） . There was no significant difference in the incidence of adverse reactions between the two groups （ P〉0. 05 ） . Conclusion Butylphthalide is effective in treating hypertensive intracerebral hemorrhage. It can effectively improve edema around the hematoma and dynamic blood pressure.