中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
3期
278-281
,共4页
储佺兵%苑瑞敏%陈广生%许家佳%徐俊
儲佺兵%苑瑞敏%陳廣生%許傢佳%徐俊
저전병%원서민%진엄생%허가가%서준
高血压脑出血%尼莫地平%乌拉地尔%血肿扩大
高血壓腦齣血%尼莫地平%烏拉地爾%血腫擴大
고혈압뇌출혈%니막지평%오랍지이%혈종확대
Hypertensive intracerebral hemorrhage%Nimodipine%Urapidil%Hematoma expansion
目的 探讨不同降血压药物对高血压脑出血后患者血肿体积及神经功能恢复的影响,为临床上脑出血后血压控制的药物选择提供参考依据. 方法 筛选出自2010年1月至2012年1月在马鞍山市十七冶医院及南京医科大学附属脑科医院神经内科住院的93例高血压脑出血患者,按随机数字表法分为尼莫地平组、乌拉地尔组及对照组.对3组患者入院时、入院后24 h、入院后72 h血肿体积以及出院时神经功能缺损程度评分进行记录. 结果 入院后24 h、72 h时,3组患者血肿体积较入院时均明显扩大,但差异无统计学意义(P＞0.05)；尼莫地平组与对照组、乌拉地尔组相比扩大较小,差异有统计学意义(P=-0.026,P=0.019；P=0.016,P=0.022).不同预后等级在3组患者间分布差异有统计学意义(P＜0.05),通过平均秩次(对照组54.38,乌拉地尔组51.19,尼莫地平组35.53)判断,尼莫地平组与对照组、乌拉地尔组相比,痊愈率高、无效率低,预后明显最好. 结论 尼莫地平作为高血压脑出血后预防早期血肿扩大的药物使用时,对预防高血压性脑出血早期血肿扩大及改善神经功能预后要明显优于乌拉地尔,可作为首选药物.
目的 探討不同降血壓藥物對高血壓腦齣血後患者血腫體積及神經功能恢複的影響,為臨床上腦齣血後血壓控製的藥物選擇提供參攷依據. 方法 篩選齣自2010年1月至2012年1月在馬鞍山市十七冶醫院及南京醫科大學附屬腦科醫院神經內科住院的93例高血壓腦齣血患者,按隨機數字錶法分為尼莫地平組、烏拉地爾組及對照組.對3組患者入院時、入院後24 h、入院後72 h血腫體積以及齣院時神經功能缺損程度評分進行記錄. 結果 入院後24 h、72 h時,3組患者血腫體積較入院時均明顯擴大,但差異無統計學意義(P＞0.05)；尼莫地平組與對照組、烏拉地爾組相比擴大較小,差異有統計學意義(P=-0.026,P=0.019；P=0.016,P=0.022).不同預後等級在3組患者間分佈差異有統計學意義(P＜0.05),通過平均秩次(對照組54.38,烏拉地爾組51.19,尼莫地平組35.53)判斷,尼莫地平組與對照組、烏拉地爾組相比,痊愈率高、無效率低,預後明顯最好. 結論 尼莫地平作為高血壓腦齣血後預防早期血腫擴大的藥物使用時,對預防高血壓性腦齣血早期血腫擴大及改善神經功能預後要明顯優于烏拉地爾,可作為首選藥物.
목적 탐토불동강혈압약물대고혈압뇌출혈후환자혈종체적급신경공능회복적영향,위림상상뇌출혈후혈압공제적약물선택제공삼고의거. 방법 사선출자2010년1월지2012년1월재마안산시십칠야의원급남경의과대학부속뇌과의원신경내과주원적93례고혈압뇌출혈환자,안수궤수자표법분위니막지평조、오랍지이조급대조조.대3조환자입원시、입원후24 h、입원후72 h혈종체적이급출원시신경공능결손정도평분진행기록. 결과 입원후24 h、72 h시,3조환자혈종체적교입원시균명현확대,단차이무통계학의의(P＞0.05)；니막지평조여대조조、오랍지이조상비확대교소,차이유통계학의의(P=-0.026,P=0.019；P=0.016,P=0.022).불동예후등급재3조환자간분포차이유통계학의의(P＜0.05),통과평균질차(대조조54.38,오랍지이조51.19,니막지평조35.53)판단,니막지평조여대조조、오랍지이조상비,전유솔고、무효솔저,예후명현최호. 결론 니막지평작위고혈압뇌출혈후예방조기혈종확대적약물사용시,대예방고혈압성뇌출혈조기혈종확대급개선신경공능예후요명현우우오랍지이,가작위수선약물.
Objective To determine whether different antihypertensive drugs may have different effects on the hematoma and prognosis of intracerebral hemorrhage (ICH) patients to provide reference for drug choices in the clinical blood pressure control of patients with ICH.Methods Ninety three ICH patients,admitted to our hospital from January 2010 to January 2012,were chosen in our study and divided into nimodipine treatment group,urapidil treatment group and control group.Hematoma volumes of the patients were recorded at admission,24 and 72 hours after admission,respectively.The neurological disability grades of the patients were also recorded at discharge.Results The hematoma expanded in all of the three groups at 24 and 72 hours of admission,but not enjoying difference as compared with that before admission (P＞0.05); the hematoma expansion in the nimodipine group was obviously restricted as compared with that in the urapidil group and control group at 24 and 72 hours of admission (P=0.026,P=0.019; P=0.016,P=0.022).Significant differences on the prognosis in the three groups were noted (P＜0.05); the function recovery in the nimodipine group was significantly better as compared with that in the urapidil group and control group (P＜0.05).Conclusion Nimodipine have better effect on the early hematoma expansion and function recovery of ICH patients as compared with urapidil; nimodipine should be first chosen in clinic.
