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目的探讨早期强化降压对高血压脑出血患者血肿、炎症及神经功能的影响。方法采用随机数字法将余杭区第一人民医院2014年1月—2016年6月间收治的168例高血压脑出血患者随机分为2组,每组84例。对照组仅给予常规降压,给予静滴硝酸甘油,维持收缩压在160~180 mm Hg。观察组给予早期强化降压,静脉泵入硝酸甘油,维持收缩压在130~140 mm Hg。通过CT结果统计2组血肿量,用Elisa法测定2组患者血清炎症因子(TNF-α、IL-1β、IL-6)水平,并采用美国国立卫生研究院卒中量表(NIHSS)评价2组患者神经功能。对数据进行统计学分析,进而探讨早期强化降压对高血压脑出血患者肿块、炎症、神经功能的影响。结果治疗1 d时,观察组血肿量明显低于对照组(P<0.05),血肿扩大比例为8.3%,显著低于对照组的20.8%(P<0.05)。治疗14 d时,2组TNF-α、IL-1β、IL-6显著降低(P<0.05),且观察组TNF-α、IL-1β、IL-6明显低于对照组(P<0.05)。治疗14 d时,2组NIHSS显著降低(P<0.05),且观察组NIHSS明显低于对照组(P<0.05)。结论早期强化降压可有效改善脑出血患者血肿、炎症和神经功能,治疗效果满意。
Objective To investigate the effects of early intensive antihypertensive therapy on hematoma, inflammation and neurological function in patients with hypertensive intracerebral hemorrhage. Methods 168 cases of hypertensive intracerebral hemorrhage admitted to the First People’s Hospital of Yuhang District from January 2014 to June 2016 were randomly divided into two groups (n = 84 in each group). Control group was given only conventional blood pressure, given intravenous nitroglycerin, maintaining systolic blood pressure in 160 ~ 180 mm Hg. The observation group was given early intensive antihypertensive, and intravenous nitroglycerin was administered to maintain systolic blood pressure at 130-140 mm Hg. The levels of serum inflammatory cytokines (TNF-α, IL-1β, IL-6) in the two groups were measured by Elisa method and the two groups were evaluated by the NIH Stroke Scale (NIHSS) Patients with neurological function. Statistical analysis of the data, and then explore the early intensive antihypertensive hypertensive intracerebral hemorrhage in patients with lumps, inflammation, neurological function. Results On the first day of treatment, the hematoma volume in the observation group was significantly lower than that in the control group (P <0.05). The proportion of hematoma expansion was 8.3%, which was significantly lower than that of the control group (20.8%, P <0.05). The levels of TNF-α, IL-1β and IL-6 in the two groups were significantly decreased (P <0.05) on the 14th day after treatment, and the levels of TNF-α, IL-1β and IL-6 in the observation group were significantly lower than those in the control group . At 14 days after treatment, the NIHSS in the two groups were significantly decreased (P <0.05), and the NIHSS in the observation group was significantly lower than that in the control group (P <0.05). Conclusions Early intensive antihypertensive treatment can effectively improve hematoma, inflammation and neurological function in patients with intracerebral hemorrhage. The therapeutic effect is satisfactory.