Relationship Between Blood Pressure And Prognosis In The Acute Stage Patients With Cerebral Hemorrhage

Background and objects: Cerebral hemorrhage is a kind of terrible disease which disserves people's health. Each year millions of people suffer the disease and the mortality and disability are high. It takes great inconvenience to our people's life. The risk factor of cerebral hemorrhage is great and it can be divided into uninterverable and interverable. The former contains age,sex,race genetic factor and so on; the latter contains hypertension,diabetes mellitus,heart disease and so on. Now it is generally accepted that hypertension is the most important independent risk factor to intracerebral hemorrhage. So now people pay more attention to the relationship between the blood pressure and prognosis of the patients who suffer intracerebral hemorrhage. Recent years,there has been many clinical researches to this problem. Internationally, there are manuals about the regulation of blood pressure to the patients who suffer intracerebral hemorrhage of acute stage. There also exists many problems about this research in our country,for example : the small sample size,the lack of consideration of other risk factors. This research collected the patients of the first hospital of Jilin university,made a strict standard,record the change of blood pressure and prognosis intimately and analysed other risk factors. We aim at to provide a basis of the relationship between the hypertension and prognosis to clinician.Method: Measure the patients'blood pressure of brachial artery use the sphygmomanometer by physician. Record patients'name,sex,age,history of past illness,bleeding part and the blood pressure of the first day,the second day,the third day,the fifth day,the seventh day,the tenth day and the fourteenth day respectively. To the patients who has been in over 14 days,we adopt the NIHSS to assess. We grade them at the first and the fourteenth day. △NIHSS=(NIHSS of the fourteenth day-NIHSS of the first day), the improve NIHSS%=△NIHSS /the first day NIHSS×100%. We divide the patients into 5 groups according to the blood pressure:group I: SBP﹤140mmHg,groupⅡ:140mmHg≤SBP≤159 mmHg,groupⅢ: 160mmHg≤SBP≤179 mmHg,groupⅣ: 180mmHg≤SBP≤220mmHg,groupⅤ: SBP>220 mmHg. Record the fatality and the mark of NIHSS of each group and then analyse the results use statistics.Result: The blood pressure in acute stage of patients who suffered cerebral hemorrhage trended to decrease automatically. The decrease degree was similar between the medication group and control group. The blood pressure of medication group decreased stably,while the control group decreased fluctuantly especially during the 2nd-5th day the systolic pressure could increase slightly. The prognosis was serious to the patients with too high or too low blood pressure. The mortality of groupⅡ(140mmHg≤SBP≤159 mmHg)was the lowest. The mortality of groupⅣandⅤwas 20.1% and 57.2% respectively. The difference of△NIHSS or the improve NIHSS% of the five groups was not significant.Conclusion: The blood pressure in acute stage of patients who suffer intracerebral hemorrhage trend to decrease automatically, so we should avoid decrease the blood pressure blindly which can lead to the insufficient blood flow of the brain. The 1st systolic pressure does not have relationship with prognosis of the acute stage, but connect tightly with fatality. When the systolic pressure between 140 and 159 mmHg,the mortality is the lowest. When the systolic pressure is higher than 160 mmHg,the mortality is higher.