Relationship Of Blood Pressure Levels,Clinical Manifestations And The Forward Neural Function Recovery In Acute Intracerebral Hemorrhage

Intracerebral hemorrhage(ICH) is one of the common and frequently diseases.It has a high mortality and morbidity.At present there have no specificity therapy for the treatment of ICH. Hypertension is a major controllable factor in acute ICH.And there has been no consistent point of the view that whether we should be given active antihypertensive therapy at home and abroad. The current study confirmed that matrix metalloproteinase-9(MMP-9) as one of the main factors of pathophysiological changes after ICH. The serum MMP-9level,the volume of ICH and severity of brain injury are positively correlated.This study aimed to analysis the relationship of the blood pressure levels within14days, the early clinical manifestations in patients of ICH and prognosis. We selected the47patients who had been treated in the Neurology Department of the Bethune First Hospital of Jilin University from August2010to November2011.They were the initial issuance of hypertensive ICH.All of them have a history of hypertension.We monitored the patient’s blood pressure levels daily during hospitalization.And we have taken the mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) during2weeks after ICH.At that same time,we haved applied the U.S. National Institutes of Health Stroke Scale (NIHSS scale) to evaluate the neurological function score at the first day, the seventh day and the fourteenth day. The patiants had been follow-up3months, using a modified Rankin Scale (mRS scale) to assess the prognosis of them.The specimens were obtained during hospitalization within24hours of onset of7days,14days of fasting serum,and applied EL1SA kit determination of serum MMP-9levels. The data obtained by the SPSS17.0statistical software for data analysis.Through the data processing and statistical analysis, we obtained the following results:In the group that the ICH volume less than30ml, the mean SBP>180mmHg group (DB≥120mmHg)compared with the SBP≤180mmHg group (DBP≤120mmHg)within14days, the MMP-9levels, the ΔNIHSS%and after3months mRS scores are significant difference (p<0.05); The ICH volume more than30ml of bleeding group, the mean SBP≤160mmHg in the14days,the MMP-9level, the ΔNIHSS%and the mRS scores after3months are significant difference (p<0.05), and have Statistically significant.So we concluded that:(1). Within24hours of the ICH, the SBP≥200mmHg, DBP≥130mmHg or the Δ SBP≥50mmHg will increase the risk of continuous hemorrhage.(2) The patients whose ICH volume less than30ml the mean SBP≤180mmHg or the mean DBP≤120mmHg during the acute phase, can effectively reduce the risk of continuous hemorrhage, and alleviate the clinical symptoms and improve prognosis.(3) The patients whose ICH volume more than30ml,the mean SBP≤160mmHg can deteriorate the early clinical manifestations, and increasing disability.(4) The serum MMP-9levels with the increase of the ICH volume increased.It reached a peak at seven days after ICH,afterwards gradually declined. The MMP-9levels changes of serum after ICH,the severity of clinical manifestations and the forward neural function damage degree are positive correlation.