摘要
目的探究颈动脉重度狭窄患者脑梗死急性期血压与病情转归的关系。方法收集发病48 h内入院的脑梗死患者。对纳入患者进行血压监测,记录入院后前3 d血压,记录患者基本资料、卒中危险因素及检查结果。使用Logistic回归分析,把出院3个月改良的Rankin量表(m Rs)作为预后评价。结果本研究总共纳入患者120例,完成随访106例。以间距10 mm Hg将收缩压分组,分析显示颈动脉重度狭窄患者脑梗死急性期收缩压与预后呈U型曲线关系。收缩压最适水平在160~170 mm Hg。调整其他预后相关因素后,多因素Logistic分析显示,当收缩压<160 mm Hg时,收缩压每降低10 mm Hg,预后不良的危险率增加68.4%(OR 1.643,95%CI 1.123~2.345,P=0.043);当收缩压≥170 mm Hg时,仅NIHSS评分为预后不良的独立危险因素(OR 1.353,95%CI 1.033~1.612,P=0.021),收缩压(P=0.066)、年龄(P=0.157)与预后并无显著相关性。结论颈动脉重度狭窄患者脑梗死急性期血压偏低提示预后不良,收缩压160~170 mm Hg可能为最适血压。
Objective To evaluate the relationship between patients' blood pressure in the acute phase of cerebral infarction caused by carotid artery severe stenosis and their outcomes. Methods In this study, a series of patients hospitalized for acute cerebral infarction caused by carotid artery severe stenosis within 48 hours of onset were collected. Blood pressures were measured for each patient on the first three days after admission. We recorded all clinical data including basic information, stroke risk factors and supporting test results. At 3 months after stroke onset, we used the modified Rankin score(m Rs) to assess the prognosis. Results A total of 120 patients were brought into the study. After grouped by the systolic blood pressure(SBP), we observed a u-shaped relationship between blood pressure and late outcome. The optimal level of SBP was 160-170 mm Hg. By multiple Logistic regression analysis showed that, SBP declined every 10 mm Hg below 160 mm Hg, the risk of late poor outcome increased by 68.4%(OR=1.643, 95% CI 1.123-2.345, P=0.043); when SBP≥170 mm Hg, SBP had no significant relationship with poor outcome. Conclusion Low blood pressure in acute cerebral infarction caused by carotid artery severe stenosis indicated a poor outcome, the optimal level of systolic blood pressure might be 160-170 mm Hg.
出处
《中华临床医师杂志（电子版）》
CAS
2017年第2期193-197,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
国家临床重点专科基金资助项目(财社[2012]122号)
关键词
颈动脉狭窄
急性脑梗死
血压
预后
Carotid stenosis
Acute cerebral infarction
Blood pressure
Prognosis
