摘要
目的探讨血压变异性与急性缺血性脑卒中静脉溶栓治疗后预后的关系,为临床血管内治疗后早期血压管理提供依据。方法通过某院病案管理系统回顾性选取2020年3月1日-2021年2月28日医院收治的急性缺血性脑卒中患者53例为研究对象。全部患者均实施静脉溶栓治疗,收集其基础资料及血压变异性参数。根据改良Rankin量表评估患者转归,将患者分为转归不良组14例和转归良好组39例。采用Logistic回归分析确定血压变异性参数与急性缺血性脑卒中患者血管内治疗预后的相关性。结果2组患者基础资料比较,差异无统计学意义,P>0.05。不良组24hSSD、dSSD、nSSD分别为15.26±2.03、13.58±1.83、12.76±1.69,均高于良好组,P<0.05,差异具有统计学意义;而其余指标比较,P>0.05,差异无统计学意义。经Logistic回归分析,得到24hSSD、dSSD及nSSD的优势比分别为2.708、2.289、3.139,3者均是患者转归不良的独立危险因素,P<0.05。结论急性缺血性脑卒中患者静脉溶栓治疗后24hSSD、dSSD及nSSD是患者转归不良的独立危险因素,与患者预后紧密相关。重视急性缺血性脑卒中患者的血压监测及其变异性有助于临床管理和预后预测。
Objectives To investigate the relationship between blood pressure variability(BPV)and prognosis after intravenous thrombolysis in acute ischemic stroke(AIS),and to provide more basis for early blood pressure management after clinical intravascular therapy.Methods Through the hospital medical record management system,53 patients with AIS treated in the hospital from March 1st,2020 to February 28th,2021 were retrospectively selected as the research object.All patients were treated with intravenous thrombolysis,and their basic data and BPV parameters were collected.According to the modified Rankin scale,the patients were divided into 14 cases in the poor outcome group and 39 cases in the good outcome group.Logistic regression analysis was used to determine the correlation between BPV parameters and the prognosis of intravascular therapy in patients with AIS.Results There was no significant difference in the basic data between the two groups(P>0.05).The 24h systolic standard deviation(24h SSD),day systolic standard deviation(d SSD),night systolic standard deviation(n SSD)of systolic pressure in the poor group were 15.26±2.03,13.58±1.83,12.76±1.69,respectively,which were higher than those in the good group(P<0.05).The other indexes were meaningless(P>0.05).Logistic regression analysis showed that the odds ratios of 24h SSD,DSD and nSSD were 2.708、2.289、3.139,respectively,which were independent risk factors for poor prognosis(P<0.05).Conclusions 24h SSD,DSD and nSSD were independent risk factors for poor prognosis of AIS patients after intravenous thrombolytic therapy,which are closely related to the prognosis of patients.Paying attention to blood pressure monitoring and its variability in AIS patients is helpful to clinical management and prognosis prediction.
作者
李宗琴
胡兰
罗军
田朕轩
王志琴
许学杰
Li Zongqin;Hu Lan;Luo Jun;Tian Zhenxuan;Wang Zhiqin;Xu Xuejie(Department of Neurology,Mianyang 404 Hospital of Sichuan Province,Mianyang 621000,Sichuan Province,China;不详)
出处
《中国病案》
2022年第12期103-106,共4页
Chinese Medical Record
基金
四川省医学会高血压疾病(泰阁)专项科研课题(2019TG34)。
关键词
缺血性脑卒中
血压
变异性
预后
Ischemic stroke
blood pressure
variability
prognosis
