Significance of haemorrhagic lacunes on MRI in patients with hypertensive cerebrovascular disease and intracerebral haemorrhage

Our purpose was to determine the frequency and signifcance of haemorrhagic lacunes (HL) on MRI in patients with a history of, or at risk for intracerebral haemorrhage. We examined 72 patients with old spontaneous intracerebral haemorrhage (ICH) using T1-and T2-weighted spin-echo sequences. MRI studies of 137 consecutive patients with cerebrovascular disease but no known ICH were also reviewed. Both groups showed about the same degree of age-related white matter change and nonhaemorrhagic lacunar infarcts, whereas the ICH group had a higher frequency of HL (12/72 patients) than the non-ICH group (6/131 patients,p<0.01). These results correlate well with reported pathological findings. We conclude that haemorrhagic lacunes found on MRI studies of patients with cerebrovascular disease may suggest a higher risk of intracerebral haemorrhage.     

微创手术治疗高血压脑出血

目的 探讨微创手术治疗高血压脑出血的临床疗效。方法 132例高血压脑出血分成微创手术组(68例)和传统开颅手术组(64例)，分析两组手术的特点和手术时机，比较两组手术治疗的疗效。结果 微创组术后GOS良好23例、中残24例、重残9例、植物生存3例、死亡9例；传统组术GOS良好16例、中残15例、重残12例、植物生存6例、死亡15例。两组超早期或早期手术均有良好的预后，而微创组效果更佳。结论 微创手术治疗高血压脑出血能明显提高临床疗效，降低病死率。     

微创术治疗高血压脑出血的临床研究

目的 探讨微创清除(微创)颅内血肿治疗高血压脑出血患者的疗效.方法 对32例(微创术组)基底节区高血压脑出血、血肿量大于60ml的患者,采用脑CT片进行穿刺点定位,YL-1型颅内血肿粉碎穿刺针对血肿进行穿刺、液化、引流,评估其病死率、好转率及治疗3周时神经功能评分,并与单纯药物治疗组(对照组32例)进行比较.结果 微创术治疗组死亡8例,病死率25.00%,好转23例,好转率71.88%;单纯药物治疗组死亡16例,病死率50.0%,好转15例,好转率46.88%.微创术组病死率显著低于单纯药物治疗组(P＜0.01),好转率则显著高于单纯药物治疗组(P＜0.01);治疗3周时,微创术组神经功能评分为15.47±3.75分,单纯药物治疗组为21.45±4.46分.两组差异有非常显著意义(P＜0.01),提示微创术治疗组患者神经功能恢复程度好于单纯药物治疗组.结论 微创术治疗高血压脑出血患者效果较好,值得临床应用.     

Elevation of oxidative stress in the aorta of genetically hypertensive mice

Hypertension is an age-dependent disorder. Oxidative stress has been suggested to play a role in aging and age-dependent disorders. The objective of this study is to examine the oxidant and antioxidant status in the aorta of a mouse model with high blood pressure (BPH). Our results showed that the level of malondialdehyde (MDA) in the aorta of BPH mice was approximately 2.6-fold higher than that of the normal blood pressure (BPN) mice, suggesting an increased in vivo oxidative stress in the arterial wall of BPH mice. In addition, the release of hydrogen peroxide (H2O2) from the aorta of BPH mice was significantly faster than that of BPN mice. To determine if the increased H2O2 release is related to a down-regulation of antioxidant enzymes in the arterial wall, we measured the activities of the major antioxidant enzymes in mouse aortas. We observed that the activities of Cu/Zn-superoxide dismutase (SOD) and glutathione peroxidase-1 in BPH mice were similar to BPN mice. On the other hand, the catalase activity in the aorta of BPH mice was significantly reduced while the activities of Mn-SOD and extracellular (EC)-SOD in the aorta of BPH mice were significantly elevated as compared with BPN mice. These results suggest that increase in SOD activity and decrease in catalase activity might be responsible for the increased release of H2O2 in the arterial wall of BPH mice.     

Prevention of hypertensive crisis with ATP during anesthesia for pheochromcytoma

In the anesthetic management of five patients undergoing excision of pheochromocytoma, adenosine triphosphate (ATP) was used for the purpose of regulating systemic arterial pressure during the period of tumor manipulation. ATP was administered at doses of 0.05–0.4mg/kg/min. Systemic arterial pressure showed a significant decrease from 162 ± 17/103 ± 11mmHg before manipulation to 136 ± 21/81 ± 10mmHg during the manipulation period. The plasma catecholamine levels showed significant increases in this period. Immediately after excision, the systemic arterial pressure was maintained at normal levels (118 ± 13/75 ± 16mmHg) by fluid replacement and discontinuation of ATP administration, subsequently becoming 129 ± 19/79 ± 16mmHg. The heart rate was very stable and tachycardia did not ocurr during the manipulation period. Only one arrhythmic episode ocurred in one patient. The systemic vascular resistance index was significantly lower during the manipulation period than before it. It was therefore considered that ATP was useful as an agent for controlling arterial pressue during the anesthesia for pheochromocytoma.(Murata K, Sodeyama O, Ikeda K et al.: Prevention of hypertensive crisis with ATP during anesthesia for pheochromocytoma. J Anesth 1: 162–167, 1987)     

血肿穿刺抽吸治疗对高血压性脑出血患者血糖及按期预后的影响

目的：探讨治疗创伤对高血压性脑出血患者血糖及按期预后的影响。方法：采用局麻血肿穿刺抽吸治疗（治疗组32例）及全麻外科手术血肿清除治疗（对照组30例）,比较术后的血糖变化,结果：治疗组血肿穿刺抽吸后血糖高峰值水平显著低于对照组（P＜0．01）,而治疗后第1,2,周血糖降至正常者治疗组显著高于对照组（P＜0．05）,病死率治疗组6．25％,对照组26．7％）,两组比较差异显著（P＜0．05）,结论：高血压性脑出血患者血肿穿刺抽吸治疗较外科手术血肿清除治疗有血糖峰值低,恢复正常的速度快,病死率低,对脑组织的损伤小等优点,值得临床推广。     

RA 642, a pyrimido-pyrimidine-derivative with vasodilating and hypertensive potency

Summary 2,2-[(4,8-bis(diethylamino)-pyrimido [5,4-d]-pyrimidine-2,6-diyl)di-(2-methoxyethyl)imino]diethanol), RA 642, combines hypertensive and vasodilating effects. In anaesthetized animals arterial blood pressure was increased by i.v. doses of 0.25–4 mg/kg in cats and 0.025–0.25 mg/kg in dogs. In conscious dogs, 25 mm increase of mean blood pressure was achieved with 0.2 mg/kg i.v. and 18.8 mg/kg p.o. Cerebral blood flow was enhanced and calculated cerebral vascular resistance was reduced by RA 642. Total peripheral resistance was diminished by 0.25–1.0 mg/kg i.v. A vasodilatation of femoral and coronary vessels was shown after intraarterial injection. This effect as well as a BaCl₂-antagonism in the isolation ileum is explained by a papaverine-like relaxant effect on smooth muscle. Activity on peripheral adrenergic receptors was excluded. Hypertension was abolished in spinalized cats, indicating a central mechanism of this effect.     

针刺对急性高血压脑出血大鼠血浆ET和CGRP调整作用

目的：探索针刺对急性高血压大鼠治疗作用机制。方法：复制急性高血压脑出血大鼠模型。观察针刺对血浆ET和CGRP的影响。结果：针刺能降低血浆ET和升高CGRP。结论：针刺对急性高血压脑出血大鼠治疗作用与其降低血浆ET和CGRP密切相关。     

妊娠期高血压疾病血尿酸测定及临床意义

目的通过测定妊高征患者血尿酸含量,估计妊高征病情发展,监测肾功能早期变化及预测妊娠结局。方法对97例妊高征患者,测定血尿酸、肌酐、尿素氮含量及尿蛋白定性检查,并选择同期正常妊娠孕晚期44例作为对照。结果轻度子痫前期组、重度子痫前期组与子痫组尿酸含量逐渐增加,差异具有显著性意义(P<0.05);尿蛋白++组、尿蛋白+++组与尿蛋白++++组组间比较血尿酸含量差异均无统计学意义(P>0.05)。肌酐、尿素氮在轻度子痫前期组、重度子痫前期组与子痫组有逐渐增加的趋势,但差异均无统计学意义(P>0.05)。围生儿体重与血尿酸含量呈负相关,不同血尿酸含量围生儿死亡率不同,随着血尿酸含量增高围生儿死亡率增加。结论血尿酸可以估计妊高征病情发展,也可作为妊高征肾功能损害比较敏感指标,与围生儿结局密切相关。     

高血压药物治疗体会

据我国卫生统计资料显示,我国高血压的患病率由20世纪50年代末的5.11%,至90年代初上升至11.26%,后十年上升了25%,我国现有高血压病人数达到1亿人以上[1]。但高血压病知晓率仅25%,治疗率12.5%,控制率只有3%,远远低于发达国家[2]。高血压是心脑血管并发症的独立危险因素。医务工作者因工作繁忙,而缺乏对高血压患者全面、细致、耐心的讲解,而使心脑血管病死率居高不下,为此对“习以为常、不以为然”的高血压病的防治工作仍任重道远。1评价高血压要对每位高血压患者确定引起高血压病的病因,明确有无靶器官的损害及有无心血管疾病存在,病程及对治…