Department of Geriatric, The Second Hospital of Baoding City, Baoding, China.
Department of Neurology, The Second Hospital of Baoding City, Baoding, China.
J Clin Hypertens (Greenwich). 2019 Sep;21(9):1325-1331. doi: 10.1111/jch.13629. Epub 2019 Jul 26.
To observe the effect of early intensive blood pressure (BP)-lowering treatment on rebleeding and perihematomal edema (PE) in patients with acute intracerebral hemorrhage (ICH). A total of 121 patients with ICH were randomly assigned to an early intensive antihypertensive treatment group (IG) (n = 62) or control group (CG) (n = 59). For both groups, 25 mg of urapidil injection was slowly administered intravenously in 6 hours of the onset. For the IG, 100 mg of urapidil and 30 mL of 0.9% sodium chloride were then slowly administered. Repeat computed tomography imaging was performed at 24 hours, 72 hours, day 7, and day 14 to detect any rebleeding via changes in hematoma volume and the changes in PE. Finally, NIHSS scores and Barthel Index (BI) were calculated at 24 hours, 72 hours, day 7, day 14, day 30, and day 90. The average hematoma volume in IG patients was significantly smaller than that of CG patients after 24 hours (P < .05). The volume of PE in the CG increased more than in the IG within 24 hours of onset, but was not statistically significant (P > .05); however, this trend was statistically significant after 72 hours (P < .05). On day 30 and day 90, the average NIHSS score of IG patients was lower than that of CG patients, and the BI was higher (P < .05) than that of CG patients. There was no significant difference in mortality between the two groups. Early intensive antihypertensive treatment in ICH patients reduces rebleeding and PE, improving short-term quality of life.
观察早期强化降压治疗对急性脑出血（ICH）患者再出血和血肿周围水肿（PE）的影响。共纳入 121 例 ICH 患者，随机分为早期强化降压治疗组（IG）（n=62）和对照组（CG）（n=59）。两组患者均在发病后 6 小时内缓慢静脉注射 25mg 乌拉地尔。IG 组随后缓慢静脉注射 100mg 乌拉地尔和 30ml 0.9%氯化钠。发病后 24 小时、72 小时、第 7 天和第 14 天重复行 CT 检查，根据血肿体积变化和 PE 变化检测再出血。发病后 24 小时、72 小时、第 7 天、第 14 天、第 30 天和第 90 天，分别计算 NIHSS 评分和 Barthel 指数（BI）。IG 组患者发病后 24 小时平均血肿体积明显小于 CG 组（P<0.05）。CG 组患者发病后 24 小时内 PE 体积增加多于 IG 组，但差异无统计学意义（P>0.05）；但在 72 小时后，差异有统计学意义（P<0.05）。第 30 天和第 90 天，IG 组患者平均 NIHSS 评分低于 CG 组，BI 高于 CG 组（P<0.05）。两组死亡率差异无统计学意义。ICH 患者早期强化降压治疗可减少再出血和 PE，改善短期生活质量。
