摘要
目的分析卒中急性期患者血压变异性的特征,并探讨卒中不同类型间血压变异性的相关性。方法本研究为前瞻性研究,连续选取首都医科大学附属北京天坛医院神经内科2012年3月至2012年12月住院的、确诊为急性卒中患者306例。根据卒中类型分为脑出血组及缺血性卒中组,其中缺血性卒中组根据中国缺血性卒中分型(China Ischemic Stroke Subclassification,CISS)分为大动脉粥样硬化亚组及非大动脉粥样硬化亚组,所有患者均完成24 h动态血压监测,收集患者24 h、白天及夜间收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、平均血压(mean blood pressure,MBP)、脉压(pulse pressure,PP)、心率(heart rate,HR)、发病后21天或出院时的改良Rankin量表(modified Rankin Scale,m RS)评分,比较各组患者的一般资料、既往病史、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)、m RS评分、MBP及血压变异性指标,包括SBP、DBP、MBP、PP的标准差(standard deviation,SD)、变异系数(coefficient of variation,CV:等于SD/平均值×100%)等。结果血压平均值显示卒中急性期血压以点增高为主,24 h MBP指标无显著增高;脑出血组的24 h DBP、白日DBP、夜间DBP以及24 h HR、白日HR、夜间HR均高于缺血性卒中组,差异具有显著性(P<0.05)。缺血性卒中组24 h PP、白日PP、夜间PP均显著高于脑出血组,差异有显著性(P<0.05)。血压变异性显示脑出血组与缺血性卒中组间血压变异性差异有显著性(SBP及MBP的标准差,SBP、DBP及MBP的血压变异性各项比较P<0.05),提示缺血性卒中的血压变异性更大;而大动脉粥样硬化性卒中与非大动脉粥样硬化性卒中比较血压变异性差异无显著性。结论卒中不同类型间血压变异性存在显著差异,其中缺血性卒中患者血压变异性更大。
Objective To analyze the characteristics of blood pressure variability（BPV） in acute stroke patients, and to explore the association between BPV and different types of stroke. Methods A prospective study was conducted among 306 consecutively admitted patients of acute stroke from the department of Neurology in Beijing Tiantan Hospital during the period from March 2012 to December 2012. Patients were divided into cerebral hemorrhage group and ischemic stroke （IS） group. The latter was further divided into large artery atherosclerosis（LAA） subgroup and non-LAA subgroup according to China Ischemic Stroke Subclassification（CISS）. Twenty four hour ambulatory blood pressure monitoring（ABPM） was tested in all the patients, and the index were recorded, including systolic blood pressure（SBP） （24-hour, day-time and night-time）, diastolic blood pressure（DBP） （24-hour, day-time and night-time）, mean blood pressure（MBP） （24-hour, day-time and night-time）, pulse pressure（PP） （24-hour, day-time and night-time）, heart rate（HR） （24-hour,day-time and night-time）, and modiifed Rankin Scale（mRS） score. mRS score was recorded when patients discharged or on the 21st day after their onset. One-way analysis of variance, chi-quare test and logistic regression were applied to evaluate the differences of the indicators between different groups, which included general information, past medical history, neurological function, mRS score, MBP, and indicators of BPV（the standard deviation[SD] and the coefficient of variation[CV] of SBP, DBP, MBP and PP）. Results A total of 306 cases of acute stroke patients were investigated, including 123 cerebral hemorrhage cases and 183 cerebral infarction（CI） cases. （1） There was no signiifcant increase in the value of 24 h-MBP in acute stroke patients. The values of 24 h-DBP, d-DBP（day-time DBP）, n-DBP（night-time DBP） , 24 h-HR, d-HR, n-HR in cerebral hemorrhage group were signiifcantly higher than those in CI group. Conver
出处
《中国卒中杂志》
2015年第10期855-860,共6页
Chinese Journal of Stroke
关键词
血压变异性
卒中
类型
大动脉粥样硬化性
Blood pressure variability
Stroke
Type
Large artery atherosclerosis
