摘要
目的探讨不同程度控制性降低血压对高血压脑出血(HICH)患者术后早期局部脑血流量(rCBF)的影响。方法27例HICH,术后随机用药物将平均动脉压(MAP)降低约10%和20%,分为A组(14例)和B组(13例),分别在发病24h、3d、7d行单光子发射计算机体层摄影术(SPECT)检查,采用感兴趣区(ROI)模型分析法,计算病灶区与对侧镜像区放射性计数的比值(Ra),进行分析和总结。结果在发病3d和7d时,A、B两组的病灶区rCBF下降比值之间的差异有统计学意义(P<0.05);当A组MAP降低约10%时,发病24h与3d之间,及当B组MAP降低约20%时,发病24h与3d及7d之间的病灶区rCBF下降比值差异有统计学意义(P<0.05)。结论在HICH术后早期,不同程度降压对rCBF下降有一定影响。在脑水肿高峰期,当MAP降低超过20%时,可导致rCBF明显下降,此时应加强脱水剂的应用及防止过度降压。
[Objective] To explore the effect of early different blood pressure control on regional cerebral blood flow （rCBF） in patients with hypertensive intracerebral hemorrhage （HICH） after craninotomy. [Methods] 27 eases patients with HICH after craninotomy were divided into group A （14 cases） and group B（13 cases） randomly by their mean arterial pressure （MAP） reduced 10% and 20%. SPECT was performed in 24 hours, 3 days, and 7 days after onset, respectively. The method of region of interesting （RO1） was used to measure the uptake counts around the hematoma regions and their enantiomerphs in the contralateral hemisphere. The data was statistically analysed. [Resuits] There was a significant difference in rCBF decrease surround the hematoma regions between group A and group B in 3 days and 7 days after onset （P 〈0.05）; There was a significant difference in rCBF decrease surround the hematoma regions between 24 hours and 3 days after onset in group A, and between 24 hours and 3 days, 24 hours and 7 days after onset in group B （P 〈0.05）. [Conclusions] Early blood pressure control to different degree had an important effect on rCBF of a patient with HICH. There would be a significant decrease of rCBF when MAP was reduced by 20%.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2007年第20期2544-2546,2549,共4页
China Journal of Modern Medicine
基金
深圳市科委立项:血压变化对高血压脑出血患者脑血流量及预后的影响(课题号:200404051)
关键词
高血压脑出血
SPECT
局部脑血流量
平均动脉压
hypertensive intracerebral hemorrhage
SPECT
regional cerebral blood flow
mean arterial pressure
