老年高血压患者局部脑血流改变对预后的影响  

The influence of regional cerebral blood flow on prognosis in hypertensive elderly

作　　者：徐仲邦[1,2] 姚薇萱[1,2] 徐尚峰[1,2] 

机构地区：[1]南京医科大学第二附属医院老年医学科 [2]江苏省人民医院核医学科

出　　处：《中华老年医学杂志》1999年第1期27-29,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨无并发症的老年原发性高血压患者的局部脑血流（ｒＣＢＦ）改变及其对预后的影响。方法对经治疗将血压控制正常的３４例住院老年高血压患者（高血压组）和３０例血压正常的老年人（对照组）应用单光子发射计算机断层扫描行ｒＣＢＦ检查，并进行随访。结果高血压组有２９例（８５．３％）ｒＣＢＦ减少，而对照组有１３例（４３．３％，Ｐ＜０．００１）。高血压病程１０～３５年者，平均每例ｒＣＢＦ减少２．７处；病程２～９年者，平均减少１．５处（Ｐ＜０．０５）。高血压组３１例、对照组２９例平均随访（３６±２２）个月，原ｒＣＢＦ减少的高血压组患者中有１２例（４１．４％）发生脑梗死，１例脑出血死亡；对照组只有１例发生脑梗死（７．７％，Ｐ＜０．０５）。结论老年高血压患者尽管经治疗将血压控制正常，但ｒＣＢＦ减少仍十分常见，是发生缺血性脑卒中的主要原因。ｒＣＢＦ减少区域的数量与病程呈正相关。及早治疗高血压和改善脑血液循环。Objective To study the influence of regional cerebral blood flow (rCBF) on prognosis in elderly patients with essential hypertension without complication.\ Methods The rCBF were measured by singlephoton emission computerized tomography in 34 elderly patients with hypertension after being treated effectively for more than two weeks and 30 normotensive elderly as control group. Follow up for (36±22) months.\ Results The rCBF were decreased in 29 of hypertensive cases (85 3%), as compared with 13 cases (43 4%) in normotensive group, with statistical significance ( P <0 001). In hypertensives with course longer than 10 35 years the rCBF decreased in 61 areas (average 2 7 areas), as compared with 16 areas (average 1 5 areas) in course of 2 9 years, with statistical significance ( P <0 05). Sixty cases (93 8%) after following up for 3 70(average 36±22 ) months, 12 cases (41 4%) suffered from cerebral infarction and one case died of intracranial hemerrhage, with complication rate 44 8% in hypertensive group. Only one case (7 7%) complicated by cerebral infarction in control group ( P <0 05).\ Conclusions The decrease of rCBF is common and is main cause of ischemic stroke in elderly hypertensives, in spite of the high blood pressure were controlled to normotensive range. The areas of the rCBF decrease bear relation to the course of hypertension. It is important to treat hypertension and improve cerebral circulation as early as possible.

关 键 词：高血压 脑动脉 老年人 预后 局部脑血流 

分 类 号：R544.107[医药卫生—心血管疾病]