Changes of vasoactive polypeptides during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage

作     者：WANG Zhi WANG Xue-feng WANG Chao LUAN Wen-zhong 

作者机构：Department of Neurosurgery Fourth Affiliated Hospital of Harbin Medical University Harbin 150001 China Department of Neurosurgery People＇s Hospital Peking University Beiiing 100044 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2007年第120卷第23期

页      面：2129-2131页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：hypertensive intracerebral hemorrhage " hypertensive crisis " vasoactive polypeptide 

摘      要：Background Hypertensive crisis could be found after operation in patients with hypertensive intracerebral hemorrhage （HICH）. The aim of this study was to explore the changes and th; roles of some vasoactive polypeptides during postoperative hypertensive crisis in patients with HICH. Methods A total of 31 patients, who were admitted for craniotomy, were enrolled into this study. After the operation, the patients were divided into three groups. Group I consisted of 9 patients with postoperative hypertensive crisis, and group Ⅱ was composed of 13 patients without postoperative hypertensive crisis. Nine patients, who denied history of hypertension or HICH, were set as group Ⅲ. The levels of some vasoactivators in the three groups were measured before and after the operation. The differences in the results among the groups were analyzed using the ANOVA. The data collected before and after the operation in the group Ⅰ was compared by Wilcoxon test. Results The concentration of endothelin in group Ⅰ was significantly higher than that in group Ⅲ （P〈0.05）. The level of thromboxane A2 and the ratio of thromboxane B2 to 6-keto-PGF1α in group Ⅰ were significantly higher than those in the other two groups （P〈0.05）. In group Ⅰ, the levels of plasma renin activity, angiotensin Ⅱ, aldosterone, catecholamine, and endothelin before the operation were significantly higher than those determined after the operation （P〉0.05）. Conclusions Postoperative hypertensive crisis may be due to the increased thromboxane A2 and relatively inadequate prostacyclin, especially 6-keto-PGF1α. The increased level of endothelin and intraoperative stimulation also play a certain role in the development of postoperative hypertensive crisis.