| 贺智杰,蔡青云.不同的降压治疗方案对高血压脑出血病人神经功能、炎症反应及预后的影响[J].安徽医药,2022,26(3):595-599. |
| 不同的降压治疗方案对高血压脑出血病人神经功能、炎症反应及预后的影响 |
| Effect of different antihypertensive therapies on neurological function, inflammatory response and prognosis in patients with hypertensive intracerebral hemorrhage |
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| DOI：10.3969/j.issn.1009-6469.2022.03.041 |
| 中文关键词: 颅内出血，高血压性 降压，控制性 强化降压 神经功能 预后 |
| 英文关键词: Intracranial hemorrhage, hypertensive Hypotension, controlled Intensive antihypertensive Neurological function Prognosis |
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| 中文摘要: |
| 目的探讨强化降压与常规降压治疗对高血压脑出血( HICH)病人神经功能、炎症反应及病人预后的影响。方法选取 2016年 3月至 2019年 3月信阳市中心医院收治的 HICH病人 108例，采用随机数字表法分为强化组和常规组各 54例，强化组采用早期强化降血压治疗( 3h内将病人收缩压降至 140 mmHg以下，并以 120~140 mmHg维持 1周)，常规组目标降压为收缩压 160~180 mmHg，平均动脉压 100~130 mmHg；对比两组病人的美国国立卫生研究院卒中量表( NIHSS)评分、格拉斯哥预后评分(GOS)、治疗前后的血浆血管性假血友病因子( vWF)、核因子 -κB(NF-κB)、高迁移率族蛋白 -1(HMGB-1)、 C反应蛋白( CRP)、脑水肿体积变化。结果治疗时间与降压方案存在交互作用，而时间因素对病人 NIHSS评分变化及脑水肿体积变化的作用均随降压方案的不同而差异有统计学意义。随着治疗时间的延长，两组病人的 NIHSS评分均呈逐渐降低的趋势，在治疗 7d、14 d时刻，强化组病人的 NIHSS评分［(6.11±2.50)分、(3.89±1.04)分］均低于对应时间点的常规组［(7.64±2.39)分、(5.08±1.30)分］(P<0.05)；治疗 7d时，强化组与常规组病人的脑水肿体积［( 27.55±6.20)mL、(30.20±5.84)mL］较治疗 3d时［( 19.64±5.52)mL、 |
| 英文摘要: |
| Objective To investigate the effects of intensive antihypertensive and conventional antihypertensive therapy on neurological function, inflammatory response and prognosis of patients with hypertensive intracerebral hemorrhage (HICH).Methods A total of 108 patients with HICH who were admitted to Xinyang Central Hospital from March 2016 to March 2019 were selected and randomly divided into an intensive group and a conventional group with 54 cases each. The intensive group was treated with early intensive antihypertensive therapy (the patient′s systolic blood pressure was reduced to less than 140 mmHg within 3 hours and maintainedat 120-140 mmHg for 1 week). The target blood pressure reduction in the conventional antihypertensive group was systolic blood pressure of 160-180 mmHg and mean arterial pressure of 100-130 mmHg. The changes in the National Institutes of Health Stroke Scale (NIHSS) scale, Glasgow Outcome scale (GOS), plasma von Willebrand factor (vWF), nuclear factor-κB (NF-κB), high mobility group box-1 (HMGB-1), C-reactive protein (CRP), and brain edema volume before and after treatment were compared between the two groups.Re? sults There was an interaction between treatment time and antihypertensive regimen, and the effect of time on the changes in NIHSSscore and brain edema volume was significantly different with different antihypertensive regimens. With the prolongation of treatmenttime, the NIHSS scores of the two groups of patients showed a decreasing trend. On the 7th and 14th days of treatment, the NIHSSscores of the patients in the intensive group [(6.11±2.50) points, (3.89±1.04) points] were lower than those in the conventional group atthe corresponding time points [(7.64±2.39) points, (5.08±1.30) points] (P < 0.05); During treatment, the brain edema volume of the patients in the intensive group and conventional group [(27.55±6.20) mL, (30.20±5.84) mL] after treatment for 7 days was significantly |
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