摘要
目的研究脑梗死急性期血压变化与预后的关系,为临床血压管理提供依据。方法采用前瞻性队列研究方法,连续登记2004年10月~2010年1月入住苏州大学附属第二医院神经内科及2004年10月~2006年8月入住苏州市立医院本部神经内科的发病24h内的脑梗死患者。连续观察入院7d内血压,记录随访6个月时死亡情况。对影响急性期预后的各因素进行Logist回归分析。结果本研究共纳入480例脑梗死患者。入院时血压与预后呈L型关系,即当收缩压（SBP）〈120mmHg,舒张压（DBP）〈70mmHg时死亡率均明显升高。7d内平均SBP与预后呈U型关系（P〈0.05）,即当SBP在120~140mmHg之间预后最好,高于或低于此范围死亡率均升高。7d内连续性变异与死亡率呈正相关,变异率越大死亡率越高。24h内血压下降率与预后呈U型关系,下降率不超过20%时预后最好（P〈0.05）。影响预后的主要血压因素为血压的连续性变异率。结论急性期血压独立影响脑梗死患者预后,入院7d内血压的处理应谨慎。
Objective To explore the relationship between blood pressure and prognosis in patients with acute cerebral infarction.Methods We studied 480 consecutive inpatients admitted within the first 24h after the onset of stroke.We collected the basic information,monitored the blood pressure values during the first 7d,graded the companion diseases,recorded the ways and the time of managing blood pressure.Stroke severity was measured with National Institutes of Health Stroke Scale（NIHSS）on admission and 6-month visits.The functional outcome was assessed on the basis of mortality or dependency（Barthel Index,BI 60）at the 6 month visits.The data was analysed with SPSS statistic software.Results In the group of cerebral infarction,we found a L-shaped relationship between admission SBP/DBP and 6-month prognosis.A U-shaped relationship was found between SBP and 6 month death and death /dependency.AU-shaped relationship was found between degression rate in 24h and prognosis.The rate between 0%~20% had a better prognosis.Logist regression analysis revealed that the the BP successive variation among 7d were related with high rate of mortality or dependency.Conclusions Blood pressure were independent prognostic factors for poor outcome in patients with acute stroke,thus the blood pressure should be cautiously handled during the first 7 day hospitalization.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2011年第4期321-323,共3页
Journal of Apoplexy and Nervous Diseases
关键词
脑梗死
血压
高血压
预后
Cerebral infarction
Blood pressure
Hypertension
Prognosis
