不同降血压药物预防高血压脑出血后早期血肿扩大的研究  被引量:43

Different antihypertensive drugs preventing early hematoma expansion in patients with hypertensive cerebral hemorrhage

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作  者:储俭兵 苑瑞敏 陈广生[1] 许家佳 徐俊[2] 

机构地区:[1]安徽省马鞍山市十七冶医院神经内科,安徽省马鞍山市243000 [2]南京医科大学附属脑科医院神经内科,南京210029

出  处:《中华神经医学杂志》2013年第3期278-281,共4页Chinese Journal of Neuromedicine

摘  要: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组患者人院时、入院后24h、入院后72h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24h、72h时,3组患者血肿体积较人院时均明显扩大,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)30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。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.

关 键 词:高血压脑出血 尼莫地平 乌拉地尔 血肿扩大 

分 类 号:R743.2[医药卫生—神经病学与精神病学]

 

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