The Effect of Admission Blood Pressure on the Prognosis of Patients with Intracerebral Hemorrhage That Occurred during Treatment with Aspirin, Warfarin, or No Drugs
The Effect of Admission Blood Pressure on the Prognosis of Patients with Intracerebral Hemorrhage That Occurred during Treatment with Aspirin, Warfarin, or No Drugs
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DOI：
10.3109/10641963.2011.601380
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发表时间：
2012-01-01
影响因子：
12.3
通讯作者：
Unlu, Ercument
中科院分区：
文献类型：
--
作者：
Balci, Kemal;Utku, Ufuk;Unlu, Ercument
背景资料。高血压是脑出血(ICH)最重要的可变性危险因素，但ICH急性期的血压管理仍存在争议。大约四分之一的ICH发生在华法林或阿司匹林治疗期间。瞄准。本研究旨在通过将脑出血患者分为三组(华法林组、阿司匹林组和不用药组)来确定入院血压对患者早期预后的影响。方法：研究方法。将369例幕上脑出血患者按用药情况分为3组。根据出院时的改良Rankin分级(MRS)评分(预后良好：MRS 3)，对每组患者的预后和死亡风险进行评估。观察两组入院BP对预后的影响。结果。接受华法林治疗的脑出血患者的住院死亡率为72%，接受阿司匹林治疗的脑出血患者的住院死亡率为41.6%，而未接受药物治疗的脑出血患者的住院死亡率为35%。阿司匹林组(P=.002)和非药物组(P=.001)预后较差的患者入院时平均动脉压(MABP)值高于预后较好的患者，而华法林(P=.067)组则不同。结论。入院时高MABP被发现是接受阿司匹林治疗或未接受药物治疗的脑出血患者预后不良的独立预测因素，但对于接受华法林治疗的脑出血患者则不是。
Background. Hypertension is the most important modifiable risk factor for intracerebral hemorrhage (ICH), but blood pressure (BP) management during the acute phase of ICH is still controversial. Approximately one-fourth of ICHs occur during treatment with warfarin or aspirin. Aim. This study was designed to determine the effect of admission BP on the early prognosis of ICH patients by dividing them into three groups (warfarin, aspirin, and no drugs). Methods. Three hundred and sixty-nine patients with supratentorial ICH were divided into three groups according to medication. Each group was evaluated in terms of prognosis and the risk for mortality based on the modified Rankin Scale (mRS) score at discharge (good prognosis: mRS 3). The effect of admission BP on prognosis was evaluated for each group. Results. The inhospital mortality rate was 72% for ICH patients treated with warfarin, 41.6% for ICH patients treated with aspirin, and 35% for ICH patients treated with no drugs. Admission mean arterial blood pressure (MABP) values were higher in patients with poor prognosis compared with patients with good prognosis for the aspirin (P = .002) and no-drug (P = .001) groups, but not in the warfarin (P = .067) group. Conclusion. A high MABP at admission was found to be an independent predictor of poor prognosis for ICH patients treated with aspirin or with no drugs, but not for ICH patients treated with warfarin.