诱导升压对动脉瘤性蛛网膜下腔出血患者脑血流量的影响

Effect of induced hypertension on cerebral blood flow in patients with aneurysmal subarachnoid hemorrhage

目的本文旨在探讨对于动脉瘤性蛛网膜下腔出血患者,诱导升压对其脑血流量的影响。方法选取2015年1月至2018年12月在我院就诊的诊断为动脉瘤性蛛网膜下腔出血的患者,随机分为诱导组和对照组。分别对两组患者实行诱导升压以及无诱导操作,在24~36小时后,评估两组患者的脑血流量(CBF),同时评估两组患者的动脉血压。结果共有24名患者被纳入到本研究中,对照组和诱导组的临床资料无统计学的差异。在本研究中,在CTP1和CTP2两个时间点之间,诱导组患者的平均动脉血压为12 mmHg(95%置信区间,8.7~14.8 mm Hg),高于对照组。诱导组的所有患者在CTP2时间点时,仍然能够耐受诱导血压的升高。诱导组患者的总CBF变化为0.1(-31~43)ml/100g/min,而对照组为-8.3(-41~30)ml/100g/min,差异没有显著的统计学意义(P=0.24)。结论诱导升压对于动脉瘤性蛛网膜下腔出血患者的脑血流量无显著的统计学影响。

Objective To investigate the effect of induced hypertension on cerebral blood flow(CBF)in patients with aneurysmal subarachnoid hemorrhage.Methods We enrolled patients diagnosed with aneurysmal subarachnoid hemorrhage in our hospital from January 2015 to December 2018,and randomly divided them into induction group and control group to receive induced hypertension and non-induction treatment,respectively.After 24 to 36 hours,CBF and arterial blood pressure were assessed in both groups.Results A total of 24 patients were included in the study.Clinical data showed no significant differences between the control and induction groups.From time point CTP1 to CTP2,mean arterial blood pressure increased by 12 mmHg(95%confidence interval,8.7 to 14.8 mmHg)in the induction group,which was higher than that in the control group.All the patients in the induction group tolerated the induced increase in blood pressure at the time of CTP2.The overall CBF change in the induction group was 0.1(-31 to 43)ml/100 g/min,while that in the control group was-8.3(-41 to 30)ml/100 g/min,showing no significant difference(P=0.24).Conclusions Induced hypertension has no significant effect on CBF in patients with aneurysmal subarachnoid hemorrhage.