Arakawa S, Saku Y, Ibayashi S, Nagao T, Fujishima M
Department of Cerebrovascular Disease, Institute of Neuroscience, St Mary's Hospital, Kurume, Japan.
Stroke. 1998 Sep;29(9):1806-9. doi: 10.1161/01.str.29.9.1806.
Recent studies have demonstrated that recurrence of hypertensive brain hemorrhage (HBH) is not uncommon. However, risk factors for the recurrence of HBH have not been evaluated systematically.
We analyzed 74 patients with HBH who were admitted to our clinic and followed up as outpatients for a mean of 2.8 years. Blood pressure (BP) and other clinical features were compared between the groups of patients with and without rebleeding. We determined the recurrence rate of HBH in relation to BP.
Diastolic BP was significantly higher in the recurrence group than in the nonrecurrence group (88+/-8 versus 82+/-7 mm Hg; P=0.04). Systolic BP and other clinical variables were not different between the groups. The recurrence rate was 10.0% per patient-year in patients with diastolic BP >90 mm Hg and <1.5% in those with lower diastolic BP (P<0.001). No patients with diastolic BP <70 mm Hg experienced rebleeding.
Higher diastolic BP was related to an increased rate of rebleeding. Diastolic BP >90 mm Hg may be regarded as a factor predictive of the recurrence of HBH.
近期研究表明，高血压性脑出血（HBH）复发并不罕见。然而，尚未对HBH复发的危险因素进行系统评估。
我们分析了74例入住我院门诊并接受平均2.8年随访的HBH患者。比较了有再出血和无再出血患者组之间的血压（BP）及其他临床特征。我们确定了与BP相关的HBH复发率。
复发组的舒张压显著高于未复发组（88±8对82±7 mmHg；P = 0.04）。两组间收缩压及其他临床变量无差异。舒张压>90 mmHg的患者每年复发率为10.0%，舒张压较低者为<1.5%（P<0.001）。舒张压<70 mmHg 的患者均未发生再出血。
较高的舒张压与再出血率增加有关。舒张压>90 mmHg可被视为HBH复发的预测因素。
