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目的 :探讨降血压治疗是否影响脑血流动力学。方法 :应用经颅多普勒超声 (TCD)诊断仪监测原发性高血压患者 32例以硝苯地平及 17例以硝苯地平 +卡托普利降血压前后的脑血流参数 ,以及 11例血压大于 2 0 0 / 130mmHg的脑出血患者不同梯度地降血压前后的TCD血流参数的变化。结果 :三组药物降血压效果均有显著性意义。高血压患者双侧大脑中动脉血流速度 (MFV)降低无统计学意义 ,PI值升高有统计学意义 ;脑出血患者不同梯度降血压健侧和患侧MFV降低、PI升高 ,均有统计学意义 ,而两组药物之间TCD参数差异无统计学意义。结论 :原发性高血压患者脑血管仍有一定的调节功能 ,脑出血患者降血压治疗可能会更降低脑灌注压 ,应慎重应用降压药。
Objective: To investigate whether hypotensive therapy affects cerebral hemodynamics. Methods: Transcranial doppler ultrasonography (TCD) was used to monitor cerebral blood flow parameters in 32 patients with essential hypertension before and after nifedipine and 17 nifedipine plus captopril before and after lowering blood pressure. Cases of blood pressure greater than 2000 / 130mmHg cerebral hemorrhage in patients with different gradient blood pressure before and after lowering the TCD blood flow parameters. Results: The blood pressure lowering effects of three groups of drugs were all significant. Hypertension patients with bilateral middle cerebral artery velocity (MFV) decreased no significant difference, PI increased statistically significant; cerebral hemorrhage patients with different gradient hypotensive blood pressure and contralateral MFV reduced PI, both Statistical significance, while the TCD parameters between the two groups showed no significant difference. Conclusion: Cerebrovascular vessels in patients with essential hypertension still have some regulatory function. Antihypertensive drugs may be used with caution in patients with cerebral hemorrhage.