Effects of early intensive antihypertensive strategy on hematoma enlargement, vWF, NF- κB and neurological function in patients with intracerebral hemorrhage
HE Xiaofei1,2, LIU Xuhong3, WANG Rong2, XU Zhong2, RONG Xiaoguo2, and XU Wenjun2
1.Medical Office,2.Department of Neurosurgery,3.Department of Neurology,Jiangsu Provincial Corps Hospital,Chinese People’s Armed Police Force,Yangzhou 225003,China
Abstract：Objective To investigate the effect of early intensive antihypertensive strategy on hematoma enlargement, von Willebrand factor (vWF), nuclear factor kappa B (NF-κB) and neurological function in patients with intracerebral hemorrhage (ICH).Methods Eighty-eight patients (82 cases completed the treatment, and 6 cases were lost to follow up)with ICH admitted to our hospital between October 2013 and October 2015 were selected as subjects. By the random number table method, the patients were equally divided into intensive antihypertensive group (42 cases completed the treatment, and 2 cases were lost to follow up) and standard antihypertensive group (40 cases completed the treatment, 4 cases were lost to follow up). The systolic blood pressure of both groups was recorded before lowering blood pressure and 1h and 24 h after it. The hematoma volume was calculated before lowering blood pressure and 24 h after it. The rate of hematoma enlargement was compared. The levels of vWF and NF-κB were determined before lowering blood pressure and 5 d after it. 14d after lowering blood pressure, the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological impairment. 90 d after lowering blood pressure, the modified Rankin Scale (mRS) was used to evaluate the short-term prognosis of patients.Results After 1h and 24h of lowering blood pressure, the systolic blood pressure of the intensive antihypertensive group(12.03±4.16)ml was lower than that of the standard antihypertensive group (P<0.05). The 24 h hematoma volume of the intensive antihypertensive group was less than that of the standard antihypertensive group (P<0.05). The rate of hematoma enlargement in the intensive antihypertensive group (4.76%) was significantly lower than that in the standard antihypertensive group (22.5%). After 5d of treatment, vWF(121.54±26.67)% and peripheral blood NF-κB(20.15±9.85)nmol/ml in the intensive antihypertensive group were significantly lower than those in the standard antihypertensive group (P<0.05). There was no significant change in NIHSS score after 14d of lowering blood pressure. The good and excellent rate of short-term prognosis of the intensive antihypertensive group (78.57%) was significantly higher than that of the standard antihypertensive group (57.5%).Conclusions Early intensive antihypertensive strategy can prevent hematoma enlargement in patients with ICH, reduce the levels of vWF and peripheral blood NF-κB, improve prognosis, and have no effect on the recovery of neurological function.
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HE Xiaofei, LIU Xuhong, WANG Rong, XU Zhong, RONG Xiaoguo, and XU Wenjun. Effects of early intensive antihypertensive strategy on hematoma enlargement, vWF, NF- κB and neurological function in patients with intracerebral hemorrhage. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(3): 276-279.
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