高血压并发急性脑血管病发病时间规律及应用培哚普利治疗的效果观察  

Rule of Onset Time of Acute Cerebrovascular Disease Complicated with Hypertension and the Effect of Perindopril Treatment

作　　者：凌佳 蔡振荣 阚丽虹 庄晓华 金炜[2] Lin Jia;Cai Zhenrong;Kan Lihong;Zhuang Xiaohua;Jin Wei(Shanghai Pudong Hospital,Shanghai 201399,China)

机构地区：[1]上海市浦东医院,上海201399 [2]上海市第一人民医院

出　　处：《中西医结合心脑血管病杂志》2017年第22期2915-2917,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：浦东新区卫生系统优秀青年医学人才培养计划(No.PWRq2014-03)

摘　　要：目的探讨高血压症病人发生急性脑血管病的发病时间规律及应用培哚普利治疗的效果。方法选取上海市浦东医院心内科2014年1月—2016年1月收治的高血压并发急性脑血管病病人60例为观察组,选取同期高血压未并发急性脑血管疾病病人60例为对照组,收集病人基础资料,并且24h动态血压检测。两组病人均给予常规药物治疗,观察组在常规治疗基础上给予培哚普利治疗,记录白天和夜间急性脑血管病发病时间及血压变化,比较两组治疗效果,采用美国国立卫生研究院卒中量表(NIHSS)评价观察组病人神经功能。结果脑出血的好发时间为上午。其次为下午,脑梗死好发于早晨、上午,腔隙性脑梗死好发时间为上午,其次为早晨,总的急性脑血管病好发时间为上午;观察组治疗前NIHSS评分为(28.89±2.37)分,治疗后为(12.23±1.38)分,差异有统计学意义(P<0.05);观察组白天和夜间收缩压(SSP)、舒张压(DSP)水平均高于对照组,差异有统计学意义(P<0.05);与白天相比,两组夜间SSP、DSP水平平均降低2mmHg,但差异无统计学意义(P>0.05);两组治疗总有效率比较差异无统计学意义。结论高血压性急性脑血管病发生与昼夜节律密切相关,好发时间为上午,可以通过血压检测预测脑血管病的发生,并且经过培哚普利治疗病人急性脑血管病临床症状好转。Objective To investigate the rule of onset time of acute cerebrovascular disease in hypertensive patients and the effect ofperindopril.Methods Sixty patients with acute cerebrovascular disease admitted in our hospital from January2012to January2016were enrolled in this study(observation group),and60patients with acute cerebrovascular disease without hypertension were ascontrol group.24hour ambulatory blood pressure was tested.The patients were treated with conventional drugs.The patients in observationgroup were treated with perindopril on the basis of routine treatment.The time of onset and blood pressure of daytime andnighttime acute cerebrovascular disease were recorded.The therapeutic effect of the two groups was compared.The National Institutesof Health Stroke Scale(NIHSS)was used to evaluate the scores of the observation group before and after treatment.ResultsIntracerebral hemorrhage occurred in the morning,followed by the afternoon.Cerebral infarction occurred in the morning,morning,lacunarinfarction occurred early morning,followed by morning.The total time of acute cerebrovascular disease was morning(28.89±2.37)and(12.23±1.38)after treatment(P<0.05).The levels of SSP and DSP in the observation group were higher than those in thecontrol group at daytime and at night(P<0.05),but there was no significant difference between the two groups(P<0.05).Therewas no significant difference in the SSP and DSP levels between the two groups(P>0.05),but there was no significant differencebetween the two groups(P>0.05).Conclusion The onset time of acute cerebrovascular disease in hypertension is closely relatedto circadian rhythm.The time of onset is morning.The occurrence of cerebrovascular disease can be predicted by blood pressure test.The clinical symptoms of acute cerebrovascular disease are improved after perindopril treatment.

关 键 词：高血压 脑血管病 发病时间规律 培哚普利 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]