中国现代医学杂志2016，Vol.26Issue(6)：32-36,5.DOI:10.3969/j.issn.1005-8982.2016.06.008
超早期强化降压对脑出血血肿扩大、血浆基质金属蛋白酶-9及神经功能的影响
Effects of super-early intensive antihypertensive therapy on intracerebral hematoma expansion, plasma MMP-9 and neurological function
巩法桃 1于立萍 1李姗姗 1焉传祝2
作者信息
- 1. 山东省滨州市人民医院 神经内科，山东 滨州 256610
- 2. 山东大学齐鲁医院 神经内科，山东 济南 250012
- 折叠
摘要
Abstract
Objective To investigate the effects of super-early intensive antihypertensive treatment on the en-largement of hematoma, plasma matrix metalloproteinase 9 (MMP-9), brain edema and neurological function in pa-tients with acute basal ganglia hemorrhage. Methods Totally 134 patients who had spontaneous super-early basal ganglia hemorrhage within the previous 4 hours were prospectively studied and randomly divided into strengthening antihypertensive group (67 cases) and normal antihypertensive group (67 cases). In the strengthening antihypertensive group 60 patients had completed three brain CT scans, while in the normal antihypertensive group 62 patients had completed three brain CT scans. The antihypertensive agents were used intravenously to reduce systolic blood pres-sure (SBP) to the level of 130-140 mmHg or 160-180 mmHg within 1 h after treatment, then SBP was maintained for 24 h. Before and after treatment, the National Institutes of Health Stroke Scale (NIHSS) score and modified Rankin Scale (mRS) score were assessed, plasma MMP-9 was detected and cranial CT was performed. The hematoma volume, number of cases of hematoma enlargement and edema volume were measured and compared be-tween both groups. Results The NIHSS score in the strengthening antihypertensive group was significantly lower than that in the normal antihypertensive group on the 14th day after treatment ( <0.05). On the 90th day after treatment,the proportion of moderately and severely disabled patients or death cases in the strengthening antihypertensive group was significantly lower than that in the normal antihypertensive group ( < 0.05). The hematoma volume and number of cases of hematoma enlargement in the strengthening antihypertensive group were significantly smaller than those in the normal group at 24 h after treatment ( < 0.05). The edema volume was significantly smaller in both groups and plasma MMP-9 level was significantly lower in the strengthening antihypertensive group than in the nor-mal group on the 5th d after treatment (all <0.05). Conclusions Super-early strengthening antihypertensive treat-ment could prevent expansion of intracerebral hematoma, relieve perihematomal edema, reduce plasma MMP-9 level, and improve neurologic function of patients with basal ganglia hemorrhage.关键词
脑出血/强化降压/血肿扩大/MMP-9/神经功能Key words
intracerebral hemorrhage/strengthening antihypertensive therapy/hematoma expansion/matrix metalloproteinase 9/neurological function分类
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巩法桃,于立萍,李姗姗,焉传祝..超早期强化降压对脑出血血肿扩大、血浆基质金属蛋白酶-9及神经功能的影响[J].中国现代医学杂志,2016,26(6):32-36,5.
