微创手术与传统手术方法对高血压脑出血患者肾素-血管紧张素系统影响的比较

摘要

目的 比较微创手术与传统手术对高血压脑出血患者肾素-血管紧张素系统(RAS)的影响.方法 选取2010年2月至2012年8月内蒙古医科大学第一附院神经外科收治的72例高血压性脑出血患者,采用完全随机方法分为观察组(38例)和对照组(34例),观察组采用微创手术治疗,对照组采用传统手术治疗,比较两组患者手术治疗后RAS水平变化情况.结果 手术后,观察组患者的PRA、AngⅡ及Ald分别为(1.2±0.3) μg/(L·h)、(56.8±12.2) ng/L、(119.4±15.7) ng/L,均明显低于对照组,且差异有统计学意义(P<0.05),而且观察组的第1、2、3天,血压的收缩压依次为(167±11)、(154±10)、(146±10) mm Hg,均明显低于对照组(P<0.05),且波动相对较小.结论微创手术治疗高血压脑出血可有效降低患者的RAS水平,值得临床广泛推广.%Objective To compare the effects of microinvasive surgery and conventional surgery on renin-angiotensin system( RAS ) in hypertensive intracerebral hemorrhage( HICH ) patients. Methods 72 HICH patients were collected from Inner Mongolia Medical University First Affiliated Hospital Department of Neurosurgery from February 2010 to August 2012,which were divided into two groups,including observation group( 38 patients with microinvasive surgery ) and control group( 34 patients with traditional surgery ). The clinical efficacy of the two groups was compared. Results After surgery,the PRA,Ang II and Ald of observation group were( 1. 2 ± 0. 3 ) μg/( L · h ),( 56. 8 ± 12. 2 ) ng/L,( 119. 4 ± 15. 7 ) ng/L, significantly lower than the control group( P < 0.05 ), and at day 1,2,3, the SBP of observation group were( 167 ±11 ) mmHg,( 154 ± 10 ) mmHg and( 146 ± 10 ) mmHg,all significantly lower than the control group( P <0.05 ), with smaller waves than the control group as well. Conclusion Microinvasive surgery for treatment of HICH can reduce RAS system level,which is worthy of widely promotion in clinical.