降压方案对高血压性脑出血患者长期预后的影响

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Abstract Objective To explore the influence of antihypertensive regimen on the long-term prognosis of patients with hypertensive intracerebral hemorrhage (HICH).Methods The case data of 324 patients with HICH discharged from Department of Neurosurgery of a class Ⅲhospital from January 1,2017 to December 31,2019 were retrospectively selected.According to the inclusion and exclusion criteria of this study,163 eligible patients were reviewed or followed up by telephone.The functional rating was performed with the modified Rankin Scale (mRS).The patients were divided into the good prognosis group (mRS＜3 points,72 cases) and the poor prognosis group (mRS≥3 points,91 cases).Firstly,the factors affecting the long-term prognosis of HICH were discussed by univariate analysis,and then the factors with P＜0.2 or close in the univariate analysis results were further analyzed by multivariate logistic regression analysis.Results Univariate analysis showed that age,drinking history,admission systolic blood pressure (SBP),chronic diseases before hospitalization,oral antihypertensive drugs (classes),Glasgow coma score (GCS) after admission,GCS score after discharge,multiple bleeding,history of antibiotic use after hospitalization and history of hematoma removal were significantly correlated with the poor prognosis of HICH patients,the differences were statistically significant (P＜0.05).Multivariate analysis by logistic regression model showed that there were chronic diseases before hospitalization (β=2.028,OR=7.597,95%CI=2.006-28.775) was an independent risk factor for poor prognosis in patients with HICH (P＜0.05).Oral antihypertensive drugs (class) (β=-0.889,OR=0.411,95%CI=0.215-0.787),discharge GCS score (β=-0.682,OR=0.506,95%CI=0.306-0.834) were protective factor for poor prognosis in patients with HICH (P＜0.05).Age (β=0.054,OR=1.055,95%CI=1.000-1.114) had a tendency to predict the poor prognosis of HICH (P=0.05).Conclusion After controlling the baseline level of patients including demographic characteristics,GCS score at discharge and factors of chronic diseases before hospitalization,this study found that the number of types of intravenous antihypertensive drugs and the course of intravenous administration have no significant impact on the long-term prognosis of HICH patients.The more types of oral antihypertensive drugs are used,the better the prognosis of patients may be.

Key words： Hypertensive intracerebral hemorrhage Blood pressure Antihypertensive drugs Prognosis

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