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目的探讨根据血浆脑利钠肽(BNP)水平对脑梗死急性期合并心力衰竭患者血压调控的指导作用。方法纳入在24 h内发病的急性脑梗死合并心力衰竭的60例患者作为研究对象,随机分为血压调控(治疗组,n=30)和对照组(n=30)。结果治疗组BNP≤105 pmol/L的患者,血压控制后心功能较对照组无明显改善,但脑损害的各项指标均较对照组加重(P均<0.05);BNP>105 pmol/L的患者,血压控制12 h后心功能稍有改善,但脑灌注和神经功能症状较对照组无好转。结论脑梗死急性期合并心力衰竭患者依据BNP水平合理地调控血压对心功能、脑血流动力学及神经系统的改善有益。
Objective To investigate the guiding effect of plasma brain natriuretic peptide (BNP) on blood pressure regulation in patients with acute cerebral infarction complicated with heart failure. Methods Sixty patients with acute cerebral infarction and heart failure who developed acute cerebral infarction within 24 hours were randomly divided into two groups: control group (n = 30) and control group (n = 30). Results After treatment with BNP ≤105 pmol / L, the cardiac function after blood pressure control was not significantly improved compared with that of the control group. However, all the indexes of brain damage were worse than those of the control group (all P <0.05); BNP> 105 pmol / L Patients, blood pressure control 12 h after a slight improvement in cardiac function, but cerebral perfusion and neurological symptoms than the control group did not improve. Conclusions The reasonable control of blood pressure according to the level of BNP in patients with acute cerebral infarction complicated with heart failure is beneficial to the improvement of cardiac function, cerebral hemodynamics and nervous system.