前列腺素E1对高血压脑出血患者血肿周围组织血流量及预后的影响  

Influence of prostaglandin E1 on regional cerebral blood flow of perihematomal tissue and prognosis in patients with hypertensive intracerebral hemorrhage

作　　者：曹茂红[1] 柯开富[1] 孙海华[2] 

机构地区：[1]南通大学附属医院神经内科,226001 [2]盐城市第三人民医院神经内科

出　　处：《临床神经病学杂志》2011年第3期180-183,共4页Journal of Clinical Neurology

摘　　要：目的观察前列腺素(PG)E1对高血压脑出血患者血肿周围组织血流量及预后的影响。方法 40例高血压脑出血患者随机分为PGE1组和对照组,两组患者均给予脑出血的常规治疗;PGE1组发病后第5d起给予PGE1治疗15 d。发病后第5 d、20 d进行单光子发射计算机断层扫描脑灌注显像,应用半定量分析法计算血肿区及血肿周围组织近区、远区及额顶叶区的局部脑血流量(rCBF);发病第1 d、第5 d、第12 d和第20 d进行头颅CT检查,观察两组患者血肿及血肿周围低密度区体积;同时应用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损程度评分;发病第1 d、第20 d进行改良的Rank in量表(mRS)评分,第90 d时再次分别进行NIHSS和mRS评分。结果发病第20 d PGE1组血肿周围近区及远区rCBF较治疗前及对照组明显升高(均P<0.01);发病第12 d、20 d时血肿体积以及发病第20 d时血肿周围低密度区较对照组明显缩小(均P<0.01);发病第20 d和第90 d时NIHSS评分较对照组明显降低(均P<0.05);发病第90 d时mRS评分较对照组明显降低(P<0.01)。结论高血压脑出血患者应用PGE1治疗,可增加血肿周围rCBF,促进神经功能缺损的恢复,改善预后。Objective To observe the influence of prostaglandin （PG）E1 on regional cerebral blood flow （rCBF） of perihematomal tissue and prognosis in patients with hypertensive intraeerebral hemorrhage （ICH）. Methods Forty hypertensive ICH patients were randomly divided into PGEI group and control group. The patients in the both groups were received ICH routine treatment. Moreover, the PGEI group was treated with PGE1 sincethe fifth day after onset. Single photon emission computed tomography brain perfusion imaging was performed at 5 d and 20 d after onset. The rCBF of hematoma, proximal and distal areas around it as well as frontal and parietal lobes were calculated by semi-quantitative analysis methods. At 1 d, 5 d, 12 d, and 20 d after onset, the volumes of perihematomal low-density areas around the hematoma were measured by skull CT scan; meanwhile, the neurologal disfunction was evaluated by scale of NIHSS. The scores of mRS at 1 d and 20 d after onset were carried out. The scores of national institutes of health stroke scale （NIHSS） of USA and meliorate Rankin scale （mRS） were carried out at 90 d after onset respectively. Results In PGE1 group, at 20 d after onset, the rCBF of proximal and distal areas of hematoma were significantly higher than before treatment and control group （ all P 〈 0.01 ） ; the volumes of hematoma at 12 d and 20 d after onset and the perihematomal low-density area at 20 d after onset were significantly lower than control group （ all P 〈 0. 01 ） ; the NIHSS scores at 20 d and 90 d after onset were significantly lower than control group （ all P 〈 0. 05 ） ; and the mRS score at 90 d after onset were significantly lower than control group （ P 〈 O. O1 ）. Conclusion Treatment with PGE1 can evidently increase rCBF of perihematomal tissue and promote the improvement of neurological function and prognosis in hypertensive ICH patients.

关 键 词：高血压性脑出血 前列腺素E1 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]