缺血性卒中急性期血压水平与卒中后认知障碍的关系

发布时间：2019-02-26 14:30

【摘要】：目的探讨缺血性卒中急性期血压水平与卒中后认知障碍的关系。方法选取发病24 h内住院的首发急性缺血性脑卒中患者796例,急性期收缩压或舒张压定义为卒中发病7 d内的平均收缩压或平均舒张压,Mo CA分值26分判定为认知障碍。对比分析患者入院时、发病14 d、发病3个月、发病6个月、12个月的Mo CA分值和认知障碍患病率,并将急性期血压值按五等分分组(Q1~Q5),采用多参数对数回归分析急性期血压水平与卒中发病3个月认知障碍的关系。结果卒中发病3个月后认知障碍(post-stroke cognitive impairment,PSCI)患病率最高(71.89%),以后各时相点逐渐下降。以Q3为参照,经多参数调整后,血压过低(Q1-SBP 102~127 mm Hg)或过高(Q5-SBP170~215 mm Hg),PSCI发病风险均高(Q1-SBP的OR=1.83,95%CI=1.64~2.28,P=0.007;Q5-SBP的OR=2.32,95%CI=1.74~2.90,P0.01)。DBP和MBP与SBP具有类似特征。结论缺血性卒中急性期血压过高或过低均是PSCI发病的风险因素,将血压维持在某一"适当水平"可能有助于降低PSCI的发病风险。
[Abstract]:Objective to investigate the relationship between blood pressure and cognitive impairment in acute stage of ischemic stroke. Methods A total of 796 patients with first-episode acute ischemic stroke who were hospitalized within 24 hours of onset were selected. Systolic blood pressure or diastolic blood pressure in acute stage was defined as mean systolic blood pressure or mean diastolic blood pressure, Mo CA score in 7 days after stroke as cognitive impairment. The Mo CA scores and the prevalence rate of cognitive impairment were analyzed at 14 days, 3 months, 6 months, 12 months after admission, and the blood pressure in acute phase was divided into five groups (Q1~Q5). Multi-parameter logarithmic regression was used to analyze the relationship between acute blood pressure level and cognitive impairment in 3 months after stroke. Results the incidence of cognitive impairment (post-stroke cognitive impairment,PSCI) was the highest 3 months after stroke (71.89%), and then decreased gradually. Using Q3 as a reference, blood pressure was too low (Q1-SBP 102 / 127 mm Hg) or too high) after multi-parameter adjustment (Q1-SBP 's OR=1.83,95%CI=1.64~2.28,P=0.007; was higher). OR=2.32,95%CI=1.74~2.90,P0.01 of Q5-SBP). DBP and MBP have similar characteristics with SBP. Conclusion High or low blood pressure in acute stage of ischemic stroke is a risk factor of PSCI. Maintaining blood pressure at a certain "appropriate level" may help to reduce the risk of PSCI.
【作者单位】：徐州医学院附属连云港医院神经内科;
【基金】：江苏省科技厅临床医学科技专项(BL2014062) 江苏省卫生厅科研基金(H2014061)~~
【分类号】：R743.3

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