急性脑卒中患者入院时平均动脉压与住院期间死亡、残疾危险性的关系  

Relationship Between Mean Arterial Pressure on Admission and Hospital Mortality and Disability In Acute Stroke

作　　者：刘梅[1] 鞠忠[1,2] 张凤山[3] 许锬[1] 佟伟军[1] 张永红[1] 

机构地区：[1]苏州大学医学部放射医学与公共卫生学院流行病学教研室,江苏苏州215123 [2]通辽市科尔沁区第一人民医院神经内科,内蒙古通辽028000 [3]通辽市医院神经内科,内蒙古通辽028000

出　　处：《中华高血压杂志》2010年第4期339-343,共5页Chinese Journal of Hypertension

摘　　要：目的探讨急性期脑卒中患者入院时平均动脉压(MAP)与其住院期间死亡、残疾危险性之间的关系。方法回顾性分析2003-01-2005-12内蒙古通辽市6家医院的3938例脑卒中患者的入院血压、血脂、血糖、疾病史以及住院期间死亡和残疾资料,采用Logistic回归模型,对入院血压与急性脑卒中患者住院期间死亡和残疾的关系进行统计分析,计算OR和95%CI。结果在出血性脑卒中患者中,调整了年龄、性别、民族、吸烟、饮酒、血脂和血糖因素后,与MAP<103 mm Hg者相比,MAP≥133 mm Hg者的死亡OR值为2.12,MAP在103～116、117～132和MAP≥133 mm Hg者的残疾OR值分别为1.85、2.15和1.99(均P<0.01)。在缺血性脑卒中患者中,各组的死亡和残疾的OR均无统计学意义。结论急性出血性脑卒中患者入院时MAP越高,其发生死亡和残疾的危险性越大。Objective To explore the role of admission mean arterial pressure（MAP） on the risk of death in-hospital and disability in acute ischemic and hemorrhagic stroke patients.Methods Observational study of 3938 patients with comfirmed stroke admitted in six hospitals in Tongliao city,Nei Mongol,from 1 January,2003 to 30 December,2005,with retrospective analysis of blood pressure,plasma lipid and plasma glucose,history and outcome.Results In multivariate logistic regress,by optimal modification of age,gender,race/ethnicity,cigarette smoking and alcohol,higher MAP（MAP≥133 mm Hg） in hemorrhagic stroke patients has an association with hospital mortality（OR 2.12） compared to those with MAP〈103 mm Hg.Also,MAP of 103-116,117-132 and ≥133 mm Hg was associated with disability with OR 1.85,2.15 and 1.99,respectively.However,there was no significant difference of death and disability among groups in ischemic stroke patients（all P〉0.05）.Conclusion Hemorrhagic stroke patients with elevated MAP on admission lead to higher risk of hospital mortality and disability.

关 键 词：平均动脉压 脑卒中 死亡 残疾 

分 类 号：R743.3[医药卫生—神经病学与精神病学]