CAJ | 학술논문

目的探讨不同程度药物降压对高血压脑出血患者局部脑血流量及预后的影响.方法 30例高血压脑出血,测得首次入院血压,根据平均动脉压降低程度分为A组(<10%)、B组(10～20%)、C组(>20%),并分别于入院24 h内、3～5 d、12～15 d行单光子发射计算机体层摄影术、头颅CT和临床疗效评定.两组间局部脑血流量下降比值差异采用t检验;两组间神经功能缺损评分、生活能力评分和再出血例数差异采用X2检验,应用SPSS 10.0统计学软件.结果 C组局部脑血流量下降比值、神经功能缺损值和生活能力评分在各期与A、B组相比差异均有统计学意义(P<0.05);A组在急性期发生再出血机会与B、C组相比差异均有统计学意义(P<0.05).结论在HICH早期,当收缩压>185mmHg或舒张压>95 mmHg时,MAP降低约15%较为安全,对患者局部脑血流量和预后影响较小.
목적 탐토불동정도약물강압대고혈압뇌출혈환자국부뇌혈류량급예후적영향.방법 30례고혈압뇌출혈,측득수차입원혈압,근거평균동맥압강저정도분위A조(<10%)、B조(10～20%)、C조(>20%),병분별우입원24 h내、3～5 d、12～15 d행단광자발사계산궤체층섭영술、두로CT화림상료효평정.량조간국부뇌혈류량하강비치차이채용t검험;량조간신경공능결손평분、생활능력평분화재출혈례수차이채용X2검험,응용SPSS 10.0통계학연건.결과 C조국부뇌혈류량하강비치、신경공능결손치화생활능력평분재각기여A、B조상비차이균유통계학의의(P<0.05);A조재급성기발생재출혈궤회여B、C조상비차이균유통계학의의(P<0.05).결론 재HICH조기,당수축압>185mmHg혹서장압>95 mmHg시,MAP강저약15%교위안전,대환자국부뇌혈류량화예후영향교소.
Objective To investigate effects of hypertensive agents on regional cerebral blood flow (rCBF)and prognosis in patients with hypertensive intracerebral hemorrhage (HICH). Method Thirty patients withFILCH were divided into group A,B and C according to mean arterial pressure(MAP) with various ranges of <10%, 10 ～ 20%, and > 20%, respectively. Patients of three groups were checked with single photon emissioncomputed tomography (SPECT),and computerized tomography of head successively, 24 hours, 3 ～ 5 days, and 12～ 15 days after admission for the assessment of therapeutic effects. The rtes of the decrease in rCBF compared be-twecn groups were analyzed with t test. Neurologic function defect scale, activities of living scale and number of re-bleeding compared between two groups were analyzed by X2 test, respectively. Results There were statisticallysignificant differences in the rate of the decrease in rCBF. The neurologic function defect scale and activities of liv-ing scale at 24 hours, 3 ～ 5 days, and 12 ～ 15 days after admission compared between group C and group A, andbetween group C and group B showed significant differences ( P < 0.05). There were statistically significant differ-enees in rebleeding during acute phase of HICH between group A and group B or group C (P < 0.05).Conclusions If the systolic blood pressure is above 185mmHg or diastolic blood pressure over 95mmHg,it is ra-tional and safe to lower the MAP by about 15% with hypotensive gents so as to minimize the impact on regionalcerebral blood flow.