在脑内出血后的MRI上,急性血压降低和缺血病变的风险在脑内出血后
Ken S Butcher1, Brian Buck2, Dar Dowlatshahi3,4
1School of Clinical Medicine, University of New South Wales, Sydney, Australia.
JAMA neurology
|April 21, 2025
概括
在急性脑内出血 (ICH) 中强烈降低血压并没有增加扩散加权成像 (DWI) 病变. 这表明,早期降低血压对于急性ICH患者来说是安全的.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 心血管医学 心血管医学
背景情况:
- 在亚急性脑内出血 (ICH) 中的扩散权重成像 (DWI) 病变表明缺血损伤,可能与血压 (BP) 降低有关.
- 急性密集血压降低和DWI病变后ICH之间的关系需要调查.
研究的目的:
- 为了测试这种假设,即急性密集的血压降低与ICH后DWI病变有关.
主要方法:
- 脑内出血急性降低血压试验2 (ICHADAPT-2) 是一项多中心的随机试验,涉及162名急性脑内出血压患者.
- 患者被随机分配到缩血压 (SBP) 目标<140毫米升或<180毫米升在发病6小时内.
- 主要终点是随机化后48±12小时MRI上急性DWI病变的发生率.
主要成果:
- 在79名患者 (48%为女性,平均年龄为71岁) 中进行了DWI.
- 在<140mmHg和<180mmHg目标群体之间,在DWI病变频率 (31%对38%),数量或体积上没有显著差异.
- 在48小时内,SBP的平均值在<140毫米升组显着较低 (平均差异为18.9毫米升).
结论:
- 强化抗高血压治疗没有影响DWI病变的频率或度在急性ICH.
- 这些发现支持在急性ICH管理中早期降低BP的安全性.
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