摘要
目的研究血压变异性与大脑中动脉(MCA)闭塞性脑梗死患者早期神经功能恶化(END)的相关性。方法选取MCA闭塞性脑梗死患者81例,根据入院7d内美国国立卫生研究院卒中量表(NIHSS评分)分为发生END(30例)、未发生END(51例),统计一般资料,并测定血压变异性指标[24h平均舒张压(24h MDBP)、24h平均收缩压(24h MSBP)、24h舒张压变异系数(24h DBP-CV)、24h收缩压变异系数(24h SBP-CV)]。比较发生END与未发生END患者的一般资料及血压变异性指标,分析END发生的影响因素,并评估血压变异性对END发生的预测价值。结果发生与未发生END患者性别、合并糖尿病、心房颤动、吸烟史、饮酒史、病因、治疗情况比较,差异无统计学意义(P>0.05);发生END患者年龄、合并高血压、入院NIHSS评分高于未发生END患者,侧支循环良好比例低于未发生END患者(P<0.05);发生END患者血压变异性指标24h MDBP、24h MSBP、24h DBP-CV、24h SBP-CV高于未发生END患者(P<0.05);Logistic回归分析结果表明,年龄、合并高血压、入院NIHSS评分、侧支循环良好、24h MDBP、24h MSBP、24h DBP-CV、24h SBP-CV均为END发生的影响因素(P<0.05);经ROC分析显示,24h MDBP、24h MSBP、24h DBP-CV、24h SBP-CV水平预测END发生的Cut-off值分别为86.40 mm Hg、155.45 mm Hg、12.61、9.28,AUC值分别为0.675、0.861、0.603、0.706。结论 MCA闭塞性脑梗死患者END发生风险较高,血压变异性是其重要影响因素,可准确预测END的发生,临床应密切监测血压水平的变化,指导治疗方案制定。
Objective To investigate the correlation between the blood pressure variability and the early neurological deterioration (END) in patients with middle cerebral artery (MCA) occlusive cerebral infarction.Methods A total of 81 patients with MCA occlusive cerebral infarction were selected.According to their National Institutes of Health Stroke Scale (NIHSS) scores within 7 days after admission,they were divided into patients with END (30 cases) and patients without END (51 cases).Their general data were counted,and the indexes of the blood pressure variability[24h mean diastolic blood pressure (24h MDBP),24h mean systolic blood pressure (24h MSBP),24h diastolic blood pressure coefficient of variation (24h DBP-CV),24h SBP coefficient of variation (24h SBP-CV)]were measured.The general data and blood pressure variability indexes of patients with and without END were compared,the influencing factors of END were analyzed,and the predictive value of the blood pressure variability for the occurrence of END was evaluated.Results There was no significant difference in gender,complication with diabetes,atrial fibrillation,smoking history,drinking history,etiology,and treatment between patients with and without END (P>0.05).The age,complication with hypertension and NIHSS score of patients with END were higher than those without END,and the proportion of good collateral circulation was lower than that of patients without END (P<0.05).The indexes of the blood pressure variability 24h MDBP,24h MSBP,24h DBP-CV and 24h SBP-CV of patients with END were higher than those without END (P<0.05).The Logistic regression analysis showed that the age,complication with hypertension,NIHSS score at admission,good collateral circulation,24h MDBP,24h MSBP,24h DBB-CV and 24h SBP-CV were all influencing factors for the occurrence of END (P<0.05).The ROC analysis showed that the Cut-off values predicted by the levels of 24h MDBP,24h MSBP,24h DBB-CV and 24h SBP-CV were 86.40 mm Hg,155.45 mm Hg,12.61 and 9.28,respectively,while the AUC values were
作者
吴德模
管义祥
邵祥忠
刘中平
蔡舒
丁锦荣
李军
WU Demo;GUAN Yixiang;SHAO Xiangzhong;LIU Zhongping;CAI Shu;DING Jinrong;LI Jun(Department of Neurosurgery,Haian People’s Hospital,Nantong 226600,China)
出处
《长春中医药大学学报》
2022年第3期323-327,共5页
Journal of Changchun University of Chinese Medicine
基金
南通市科技计划项目(CYP2C19)
江苏省自然科学基金项目(BK20170948)。
关键词
大脑中动脉闭塞性脑梗死
早期神经功能恶化
血压变异性
相关性
middle cerebral artery occlusive cerebral infarction
early neurological deterioration
blood pressure variability
correlation
