屏气试验在指导老年高血压并腔隙性脑梗死患者降压治疗中的应用  

Application of Breath holding Test in the Guidance ofAntihypertensive Treatment for Hypertensive Patients with Lacunar Infarction

作　　者：庞国防[1] 吕泽平[1] 杨珈玲[2] 胡才友[1] 江文宇[1] 韦德湛[2] 潘文晶[1] 

机构地区：[1]广西壮族自治区江滨医院神经内科,南宁市530021 [2]广西壮族自治区江滨医院多普勒室,南宁市530021

出　　处：《中国超声医学杂志》2004年第11期817-820,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西自然科学基金资助课题 [桂科自:No.0007062]

摘　　要：目的　探讨屏气试验 (BHT)作为指导老年高血压合并腔隙性脑梗死患者 (简称实验组 )降压治疗辅助检查的应用价值。方法　实验组在不同血压水平下分别进行屏气试验 ,利用 TCD测定其脑血流动力学参数。结果　 (1 )与正常对照组比较 ,实验组大脑中动脉平均血流速度 (Vm)明显降低 (P<0 .0 1 ) ;而降压治疗前、后 Vm无统计学差异 (P>0 .0 5 ) ;(2 )闭气指数 (BHI)及 Vm上升率检测 :实验组降压治疗前较正常对照组明显下降 (P<0 .0 1 ) ;平均动脉压 (MAP)下降约 1 2 .7%时 ,较降压治疗前有所改善 ,但无统计学差异 (P>0 .0 5 ) ;MAP下降约 2 2 .6 %时 ,较治疗前显著提高 (P<0 .0 1 ) ;(3)在 1 2 .7%和 2 2 .6 %的降压幅度分别有 6 %和 1 9%患者出现 BHI及 Vm上升率下降 ,但两者发生率无统计学差异 (P>0 .0 5 )。结论　实验组存在明显的脑血流灌注下降 ,脑血管反应性降低 ;持续较低的降压治疗总体是有益的 ,但需注意个体化原则 ;Objective To evaluate the value of breath holding test (BHT) in the guidance of antihypertensive treatment for hypertensive patients with lacunar infarction.Methods Hemodynamic parameters in the study group were measured with BHT in different levels of blood pressure.Results (1)The velocities of blood flow of the middle cerebral arteries(Vm) in the study group were lower than those in the control group ( P <0 01),but were not significantly different between pre and post treated patients ( P >0 05) (2) The BHI and the elevation rate of Vm (Vm↑%):The BHI and Vm↑% in pre treated patients were lower than those in the control group ( P <0 01) ;BHI and Vm↑% were increased than those in pre treated when the mean artery pressure(MAP) was decreased 12 7 %,but there was no significant difference( P >0 05), however,there was significant difference when the MAP was decreased 22 6 % ( P <0 01) ;(3) BHI and Vm↑% were reduced in 6 % and 19 % patients when the MAP was decreased 12 7 % and 22 6 %,but no significant difference was present( P >0 05).Conclusions Poor cerebral infusion and the impairment of cerebrovascular reactivity were observed in the study group To lower the blood pressure level is beneficial for patients,but attention should be paid to treat patients according to individualization principle BHT can be applied in the guidance of antihypertensive treatment.

关 键 词：降压治疗 屏气 患者 老年高血压 腔隙性脑梗死 对照组 正常 指导 实验 结论 

分 类 号：R544.1[医药卫生—心血管疾病] R743.33[医药卫生—内科学]