早期强化降压对高血压脑出血患者预后的影响

Effect of early intensive antihypertensive therapy on prognosis of hypertensive intracerebral hemorrhage patients

目的 探讨早期强化降压方案对急性高血压脑出血患者血肿扩大及预后的影响。方法 选取苏州大学附属第一医院2020年1月至2021年8月收治的急性高血压脑出血患者88例,随机将其分为强化降压组和目标降压组,每组各44例。比较两组治疗前后颅内出血量和格拉斯哥昏迷评分(GCS)变化。结果 治疗24 h后强化降压组出血量低于目标降压组[10.57(2.25,13.43) ml vs 13.35(5.59,22.78) ml,Z=2.337,P=0.019]。重复测量资料方差分析显示,两组患者治疗前后的GCS评分时间效应和组间效应显著,差异具有统计学意义(F=26.968,P<0.01;F=34.809,P<0.01),时间和分组不存在交互作用(F=1.091,P=0.355)。结论 强化降压治疗可降低血肿扩大风险,有助于改善高血压脑出血患者预后。

Objective To investigate the effect of early intensive antihypertensive therapy on hematoma expansion and prognosis in patients with acute hypertensive intracerebral hemorrhage.Methods A total of 88 patients with acute hypertensive intracerebral hemorrhage admitted to the First Affiliated Hospital of Soochow University from January 2020 to August 2021 were selected and divided into intensive antihypertensive group and target antihypertensive group randomly(n=44,each).The intracranial hemorrhage volume and Glasgow Coma Scale(GCS)before and after treatment were compared between the two groups.Results After 24 hours of treatment,the volume of intracranial hemorrhage in the intensive antihypertensive group was lower than that in the target antihypertensive group[10.57(2.25,13.43)ml vs 13.35(5.59,22.78)ml,Z=2.337,P=0.019].Analysis of variance for repeated measurement data showed that the time effect and inter group effect of GCS scores before and after treatment in the two groups were significant(F=26.968,P<0.01;F=34.809,P<0.01).But there was no interaction between time and grouping(F=1.091,P=0.355).Conclusion Intensive antihypertensive therapy can reduce the risk of hematoma expansion and help improve the prognosis of hypertensive intracerebral hemorrhage patients.