Stroke:高血压对动脉瘤性蛛网膜下腔出血后迟发性脑缺血的影响

2015-11-08 崔倩 译 MedSci原创

诱发高血压对于治疗动脉瘤性蛛网膜下腔出血后迟发性脑缺血的假设的作用只是基于没有对照的病例基础上的。研究人员在一项随机临床试验中评估了诱发高血压对动脉瘤性蛛网膜下腔出血患者迟发性脑缺血的脑血流(CBF)的影响。动脉瘤性蛛网膜下腔出血患者在迟发性脑缺血发作时被随机分为诱发或无诱发高血压(对照组)。 CBF评估,双盲治疗分配,迟发性脑缺血发作和研究治疗后24至36小时CT灌注在标准化的预先限定的区域进行

诱发高血压对于治疗动脉瘤性蛛网膜下腔出血后迟发性脑缺血的假设的作用只是基于没有对照的病例基础上的。研究人员在一项随机临床试验中评估了诱发高血压对动脉瘤性蛛网膜下腔出血患者迟发性脑缺血的脑血流(CBF)的影响。

动脉瘤性蛛网膜下腔出血患者在迟发性脑缺血发作时被随机分为诱发或无诱发高血压(对照组)。 CBF评估,双盲治疗分配,迟发性脑缺血发作和研究治疗后24至36小时CT灌注在标准化的预先限定的区域进行。平均动脉压(线性混合模型)在组间进行了比较。主要成果的措施是整体CBF变化的差异(Mann-Whitney U检验)。

高血压组的平均动脉血压为12mmHg(95%置信区间,8.6-14.5)(n=12)比对照组(n=13)高。对照组的整体CBF变化为-8.5(mL/100g per s每秒)(范围,-42〜30),高血压组为0.1(范围,-31〜43)(P=0.25)。

整体CBF的变化在组间没有统计学显著差异。根据该结果,每组需要225到250名患者在诱发高血压和无高血压组来找到整体CBF的统计学显著差异。

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