RESUMO
Twenty-three patients with hypertensive intracerebral hemorrhage, aged from 41 to 72 years, have been examined. The mean volume of hemotoma was 18,8+/-3,1 cm3. Patients of the control group (n=12) received standard treatment. The index group of patients (n=11) received additionally 20 mg of simvastatin daily for 30 days. Levels of cholesterol, low-density lipoprotein, number of venous circulating endothelial cells were measured in the peripheral blood. Outcomes were assessed using the modified Rankin scale. Patients with hypertensive intracerebral hemorrhage had disturbances of lipid metabolism and signs of endothelial dysfunction which manifested itself in the reduction of endothelium-dependent vasolidation and increase of circulating endothelial cell number. The study showed that the use of simvastatin normalized the lipid blood spectrum, improved the endothelial function and decreased unfavorable outcomes by 22%.
Assuntos
Colesterol/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Hemorragia Intracraniana Hipertensiva/tratamento farmacológico , Sinvastatina/administração & dosagem , Adulto , Idoso , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/fisiopatologia , Relação Dose-Resposta a Droga , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiopatologia , Feminino , Seguimentos , Humanos , Hemorragia Intracraniana Hipertensiva/sangue , Hemorragia Intracraniana Hipertensiva/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Vasodilatação/efeitos dos fármacosRESUMO
An analysis of results of surgical treatment of 79 patients aged from 41 to 72 years with hypertensive intracerebral hematomas of supratentorial localization has shown that results of surgical treatment depended on the severity of the patients' state, the degree of impairment of consciousness, volume and localization of hematoma, ventricular hemorrhage and in less degree on the terms of operation and the degree of displacement of the median structures of the brain. The endoscopic techniques proved to be preferential in hematomas of the lateral and mixed localizations with the volume not more than 60 cm3. The developed method using a cannula allowed abandon open operations in most patients with the lateral and mixed hematomas. The postoperative lethality became less by 9.9%.