重度妊娠高血压综合征患者脑灌注压变化及其临床意义

来源 :中国医科大学学报 | 被引量 : 0次 | 上传用户:sunjuanhuahard
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目的 :通过检测重度妊娠高血压综合征 (妊高征 )脑灌注压变化 ,探讨脑灌注压变化与头痛症状的关系。方法 :选择重度妊高征 6 9例为实验组 ,正常晚期妊娠妇女 10 0例为对照组 ,采用Aaslid评估脑灌注压方法检测脑灌注压 ,评价妊高征患者脑灌注压变化及与头痛症状的关系。结果 :重度妊高征患者中异常脑灌注压患者明显多于正常脑灌注压患者 (P <0 .0 5 )。严重头痛和轻中度头痛患者脑灌注压均异常 ,且均以脑灌注压增高为多 (P<0 .0 5 )。在脑灌注压增高组中 ,严重头痛组脑灌注压明显高于轻中度头痛组 (P <0 .0 5 ) ;而在脑灌注压减低组中 ,严重头痛组脑灌注压又显著低于轻中度头痛组和无头痛症状组 (P <0 .0 5 )。 3组重度妊高征间平均动脉压比较无显著差异 (P >0 .0 5 )。无头痛症状组有脑灌注压正常和脑灌注压轻度降低 2种状态。结论 :高脑血流灌注状态和低脑血流灌注状态均可导致妊高征脑损害。高脑灌注压和低脑灌注压均是妊高征患者头痛发生的病理生理机制。高脑灌注压是妊高征头痛症状的主要原因 ,高脑灌注压患者更有发生子痫的危险 Objective: To investigate the relationship between changes of cerebral perfusion pressure and headache by detecting changes of cerebral perfusion pressure in severe pregnancy-induced hypertension (PIH). Methods: Sixty-nine cases of severe PIH were selected as the experimental group, and 10 cases of normal pregnant women as the control group. The brain perfusion pressure was measured by Aaslid method. The changes of cerebral perfusion pressure in patients with PIH and the relationship with headache Relationship. Results: Patients with severe PIH had more abnormal cerebral perfusion pressure than those with normal cerebral perfusion pressure (P <0.05). Cerebral perfusion pressure was abnormal in patients with severe headache and mild to moderate headache, and the cerebral perfusion pressure increased significantly (P <0.05). In the group with increased cerebral perfusion pressure, the cerebral perfusion pressure in severe headache group was significantly higher than that in mild to moderate headache group (P <0.05), while in the group with reduced cerebral perfusion pressure, the cerebral perfusion pressure in severe headache group was significantly lower than that in mild headache group Mild to moderate headache group and no headache symptom group (P <0.05). There was no significant difference in average arterial pressure among the three groups (P> 0.05). No symptoms of headache in patients with normal cerebral perfusion pressure and cerebral perfusion pressure decreased slightly 2 kinds of states. Conclusion: Cerebral perfusion and cerebral hypoperfusion can lead to PIH brain damage. High cerebral perfusion pressure and low cerebral perfusion pressure are the pathophysiological mechanisms of headache in PIH patients. High cerebral perfusion pressure is the main cause of PIH headache symptoms, high risk of eclampsia occurred in patients with high perfusion pressure
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