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抗肾上腺素能药物与脑出血后水肿的发生。

Anti-adrenergic medications and edema development after intracerebral hemorrhage.

机构信息

Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, MC 3401, Farmington, CT 06030, USA.

出版信息

Neurocrit Care. 2011 Jun;14(3):395-400. doi: 10.1007/s12028-010-9498-z.

Abstract

BACKGROUND

Use of antihypertensive medications is common after intracerebral hemorrhage (ICH). Medications that block adrenergic activation (e.g., beta-blockers and the alpha(2)-agonist, clonidine) may reduce the inflammatory response and therefore have secondary benefit after ICH.

METHODS

The patients with acute ICH enrolled in the placebo arm of the CHANT trial were included. Univariate and multivariate analyses were undertaken for factors associated with blood pressure medication use, edema at 72 h, and clinical outcome at 90 days.

RESULTS

Of the 303 patients, 87.8% received some antihypertensive treatment during the first 72 h of hospitalization. Edema volume on neuroimaging at 72 h was independently associated with clinical outcome. Use of anti-adrenergic medications was associated with less edema after controlling for hemorrhage volume and blood pressure.

CONCLUSIONS

Antihypertensive medications that antagonize the sympathetic nervous system may reduce perihematomal edema after ICH.

摘要

背景

脑出血(ICH)后常使用抗高血压药物。阻断肾上腺素能激活的药物(如β-受体阻滞剂和α2-激动剂可乐定)可能减轻炎症反应,因此在 ICH 后具有二级获益。

方法

纳入 CHANT 试验安慰剂组的急性 ICH 患者。采用单变量和多变量分析,确定与血压药物使用、72 小时水肿和 90 天临床结局相关的因素。

结果

在 303 例患者中,87.8%在住院的前 72 小时接受了某种降压治疗。神经影像学上的水肿体积与 90 天的临床结局独立相关。在控制血肿量和血压后,使用抗肾上腺素能药物与水肿减少相关。

结论

拮抗交感神经系统的降压药物可能减少 ICH 后血肿周围水肿。

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