血压变异性对脑卒中后认知功能的影响

发布时间：2018-03-10 22:50

本文选题：卒中　切入点：认知障碍　出处：《中华老年心脑血管病杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨缺血性脑卒中急性期血压变异性与脑卒中后认知功能障碍(PSCI)的关系。方法选取发病24h内住院的首发缺血性脑卒中的患者786例,计算7d内血压变异系数(CV),收缩压变异系数(SBPV)分组:SBPV分组:Q1组158例,4.5~7.7,Q2组157例,7.8~8.1,Q3组157例,8.2~8.5,Q4组157例,8.6~9.2,Q5组157例,9.3~15.1;舒张压变异系数(DBPV)分组:Q1组158例,3.7~6.9,Q2组157例,7.0~7.5,Q3组157例,7.6~8.2,Q4组157例,8.3~8.8,Q5组157例,8.9~14.6。采用多参数logistic回归分析发病7d内CV水平与发病3个月PSCI的关系。结果与入院时比较,发病14d、3、6、12个月PSCI发病率升高(30.2%,72.0%,62.0%,30.3%vs 19.2%,P0.05),发病3个月时,SBPV五分位组中,与Q1组比较,Q2组、Q3组、Q4组和Q5组PSCI发生率明显升高(72.8%,74.6%,74.8%,78.8%vs 59.4%,P0.01),在DBPV各五分位组PSCI发生率无显著差异(P0.05)。以Q1组为参照,Q2组、Q3组、Q4组和Q5组3个月时PSCI发病风险升高(OR=1.91,2.20,2.07和2.88,P0.05)。结论缺血性脑卒中急性期SBPV是PSCI的独立风险因素,对发病3个月患者的视空间和执行能力、命名、延迟回忆功能影响尤为突出。
[Abstract]:Objective to investigate the relationship between blood pressure variability and cognitive dysfunction (PSCI) after ischemic stroke. Methods 786 patients with first ischemic stroke were selected within 24 hours after stroke onset. Calculate the coefficient of variation of blood pressure within 7 days (CVN, SBPV) divided into two groups: 1: SBPV, divided into two groups: group 1, 158 cases, group 1, 158 cases, group 2, group 157, group 7. 8, 8. 1 Q3, group 157, group 8. 2, 8. 5, group Q4, 157 cases, group 8. 69.2Q5, group 157, group 157, the DBPV1 group: 158 cases, group 3, group 3, group 3, group 7. 7. 5 Q3: 157 cases, group 7. 68.2Q4, group 157, group 7: 157, group 7. 7. There were 157 cases in group 8. 3 and 8. 8 Q5. Multiparameter logistic regression analysis was used to analyze the relationship between CV level within 7 days of onset and PSCI at 3 months after onset. The results were compared with those at admission. After 14 days of onset, the incidence of PSCI was increased by 30.2% and 62.0% at 12 months after onset, and 30.3% vs 19.2P0.05%, and 3 months after the onset of the disease, the incidence of PSCI was found in the five-position group. Compared with Q1 group, the incidence of PSCI in Q4 and Q5 groups was significantly higher than that in Q1 group. The incidence of PSCI in Q2 group was significantly higher than that in Q2 group, Q4 group and Q5 group. The incidence of PSCI in Q2 group was significantly higher than that in Q5 group. The incidence of PSCI in Q2 group was significantly higher than that in Q2 group, Q4 group and Q5 group. The incidence of PSCI in Q2 group was significantly higher than that in Q3 group and Q5 group. The incidence of PSCI in Q2 group was significantly higher than that in Q5 group. The incidence rate of PSCI in Q4 group and Q5 group was significantly higher than that in Q1 group. The incidence rate of PSCI in Q3 group and Q4 group and Q5 group was significantly higher than that in Q1 group. Conclusion SBPV is an independent risk factor for PSCI in acute ischemic stroke. The visual space and executive ability, naming and delayed recall function of 3 months were especially affected.
【作者单位】：徐州医科大学附属连云港医院神经内科;
【基金】：江苏省科技项目(BL2014062) 江苏省卫生厅科研基金(H2014061)
【分类号】：R743.3

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