非心源性脑梗死患者急性期血压变异与早期神经功能恶化的相关性研究

发布时间：2018-10-21 13:17

【摘要】：目的探讨非心源性脑梗死患者急性期24 h血压变异和早期神经功能恶化的关系。方法采用病例对照研究方法连续登记急性非心源性脑梗死患者,收集一般临床资料,连续血压监测并计算24 h血压变异的各参数,按照入院7 d内有无发生脑梗死早期神经功能恶化进行分组比较,建立Logistic回归模型分析24 h血压和血压变异参数与早期神经功能恶化的关系。结果 221例入组患者中59例(26.7%)出现早期神经功能恶化。出现早期神经功能恶化组24 h平均收缩压和收缩压变异系数显著高于未发生组[(145.8±18.2)mm Hg vs.(139.9±20.3)mm Hg;9.0(7.3~11.2)vs.8.4(6.9~10.2)],差异均有统计学意义(P0.05)。多因素校正后,24 h平均收缩压水平和收缩压变异系数增大是发生早期神经功能恶化的独立危险因素(每10 mm Hg 24 h平均收缩压OR=1.285,95%CI(1.059~1.559);收缩压变异系数OR=1.206,95%CI(1.050~1.384))。结论入院后24 h收缩压变异增大是急性非心源性脑梗死7 d内发生早期神经功能恶化的危险因素。
[Abstract]:Objective to investigate the relationship between 24 h blood pressure variation and early neurological deterioration in patients with non-cardiogenic cerebral infarction. Methods A case-control study was conducted to continuously register patients with acute non-cardiogenic cerebral infarction, to collect general clinical data, to monitor blood pressure continuously and to calculate the parameters of 24 h blood pressure variation. Logistic regression model was established to analyze the relationship between 24 h blood pressure and blood pressure variation parameters and the deterioration of early neurological function according to whether or not there was early neurological deterioration in patients with cerebral infarction within 7 days after admission. Results among 221 patients, 59 (26.7%) had early neurological deterioration. The mean systolic blood pressure and systolic blood pressure coefficient of variation were significantly higher in the group with early neurological deterioration than in the group without onset [(145.8 卤18.2) mm Hg vs. (139.9 卤20.3) mm Hg;9.0 (7.3n11.2) vs.8.4 (6.9 卤10.2)], and the difference was statistically significant (P0.05). After multivariate adjustment, 24 h mean systolic blood pressure level and increased systolic blood pressure coefficient of variation were independent risk factors for early neurologic deterioration (10 mm Hg / 24 h mean systolic blood pressure OR=1.285,95%CI (1.059 卤1.559); systolic blood pressure coefficient of variation OR=1.206,95%CI (1.050 卤1.384).) Conclusion the increase of systolic blood pressure variation 24 hours after admission is a risk factor for early neurological deterioration within 7 days of acute non-cardiogenic cerebral infarction.
【作者单位】：东莞市人民医院神经内科;
【基金】：东莞市社会科技发展项目(编号:201650715000222) 广东省医学科学技术研究基金(编号:A2013836)
【分类号】：R743.3

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