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血压变异性与急性缺血性卒中患者早期神经功能恶化的相关性 被引量:4

Correlation between blood pressure variability and early neurological deterioration in patients wilh acute ischemic stroke
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摘要 目的探讨早期血压变异性与急性缺血性卒中患者早期神经功能恶化(early neurological deterioration, END)的相关性。方法前瞻性收集住院治疗的急性缺血性卒中患者。连续记录入组患者入院72 h内的血压值,计算收缩压(systolic blood pressure, SBP)和舒张压(diastolic blood pressure, DBP)的平均值(mean)、最大值(maximum, max)、极差(differences between the maximum and minimum, max-min)、标准差(standard deviation, SD)和变异系数(coefficient of variation, CV)。END定义为美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale, NIHSS)最高时的评分较基线增加≥2分。采用多变量logistic回归分析在校正混杂因素后确定不同血压变异性参数与急性缺血性卒中后END的独立相关性。结果共纳入128例急性缺血性卒中患者,其中男性75例,女性53例;平均年龄(63.30±11.82)岁。经过标准治疗,35例(27.34%)患者在入院72 h内发生END。END患者与非END患者年龄、性别、糖尿病、基线NIHSS评分、C反应蛋白以及SBPmax、SBPmax-min、SBPSD、SBPCV、DBPmax、DBPmax-min、DBPSD和DBPCV的差异有统计学意义(P〈0.05)。多变量logistic回归分析表明,血压变异性指标中的SBPmax-min[优势比(odds ratio, OR)1.040,95%可信区间(confidence interval, CI)1.014~1.067]、SBPSD(OR 1.191,95% CI 1.052~1.347)、SBPCV(OR 1.317,95% CI 1.100~1.578)、DBPmax-min(OR 1.076,95% CI 1.018~1.138)、DBPSD(OR 1.508,95% CI 1.128~2.016)和DBPCV(OR 1.338,95% CI 1.093~1.638)是急性缺血性卒中患者发生END的独立危险因素。结论急性缺血性卒中患者72 h内血压变异性与END显著相关。 Objective To investigate the correlation between early blood pressure variability and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Inpatients with acute ischemic stroke were collected prospectively. The blood pressure values of the enrolled patients were recorded continuously for 72 h after admission. The mean value (mean), maximum value (max), differences between the maximum and minimum (max-min), standard deviation (SD), and coefficient of variation (CV) for the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated. END was as an increase of at least 2 in the highest score of the National Institute of Health Stroke Scale (NIHSS) compared to the baseline. Multivariate logistic regression analysis was used to identify the independent correlation between the different blood pressure variability parameters and END following acute ischemic stroke after adjusting the confounding factors. Results A total of 128 patients with acute ischemic stroke were enrolled, including 53 females and 75 males, and their mean age was 63.30 ± 11.82 years. After standard treatment, 35 patients (27. 34% ) developed END within 72 h after admission. There were significant differences in age, sex, diabetes mellitus, baseline NIHSS, C-reactive protein and SBPmax, SBPmax-min, SBPSD, SBPCV, DBPmax,DBPmax-min, DBPSD, and DBPCV between END group and non-END group (all P 〈0. 05). Multivariate logistic regression analysis showed that SBPmax-min(odds ratio [ OR ] 1. 040, 95% confidence interval [ CI] 1. 014- 1. 067, SBPsD(OR 1. 191, 95% CI 1. 052-1. 347), SI3Pcv(OR 1.317, 95% CI 1. 100-1. 578), DBP re(OR 1. 076, 95% CI 1. 018-1. 138), DBPsD(OR 1. 508, 95% CI 1. 128-2. 016), and DBPcv(OR 1. 338, 95% CI 1. 093-1. 638) in blood pressure variability indices were the independent risk factors for END in patients with acute ischemic stroke. Conclusion Blood pressure variability is significantly associated with END with
作者 段作伟 符长标 唐铁钰 刘一辉 张新江 Duan Zuowei, Fu Changbiao, Tang Tieyu, Liu Yihui, Zhang Xinjiang( Department of Neurology, Yangzhou No.1 People's Hospital, Yangzhou 225001, China)
出处 《国际脑血管病杂志》 2017年第7期621-625,共5页 International Journal of Cerebrovascular Diseases
基金 扬州市科技局社会发展项目(YZ2015048)
关键词 卒中 脑缺血 血压 高血压 预后 危险因素 时间因素 Stroke Brain Ischemia Blood Pressure Hypertension Prognosis Risk Factors Time Factors
作者简介 通信作者:张新江,Email:lzhangxinjiang@sina.com
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