急诊来院缺血性脑卒中急性期患者血压变异性与预后的临床研究  

Clinical Study of Blood Pressure Variability and Prognosis in Patients with Acute Ischemic Stroke in the Emergency Department

作　　者：赵艳[1] 李勇[2] 杨月丽 

机构地区：[1]沈阳市第二中医医院,辽宁沈阳110101 [2]武警辽宁总队医院

出　　处：《中国医学创新》2016年第9期43-46,共4页Medical Innovation of China

摘　　要：目的:研究缺血性脑卒中急性期(AIS)患者血压变异性与预后的相关性。方法:选择2014年1月-2015年6月在沈阳市第二中医医院急诊病区住院治疗的90例患者作为研究对象,对其分别按照收缩压、舒张压的24 h压差各分为3组,之后采用常规治疗,统计治疗后(30±1)d、(90±2)d、(180±3)d患者NIHSS及ADL评分变化情况,利用统计软件对结果进行分析。结果:治疗后(30±1)d时,24 h SBP SD<25 mm Hg组的NIHSS及ADL评分均明显优于SBP SD其他两组,且25 mm Hg≤24 h SBP SD<50 mm Hg组的NIHSS及ADL评分均明显优于24 h SBP SD≥50 mm Hg组;24 h DBP SD<15 mm Hg组均优于DBP SD其他两组,比较差异均有统计学意义(P<0.05或P<0.01)。在(90±2)d时,24 h SBP SD<25 mm Hg组的NIHSS及ADL评分均明显优于25 mm Hg≤24 h SBP SD<50 mm Hg组,25 mm Hg≤24 h SBP SD<50 mm Hg组均优于24 h SBP SD≥50 mm Hg组,15 mm Hg≤24 h DBP SD<30 mm Hg组均优于24 h DBP SD≥30 mm Hg组,比较差异均有统计学意义(P<0.05);24 h SBP SD<25 mm Hg组均明显优于24 h SBP SD≥50 mm Hg组,24 h DBP SD<15 mm Hg组均明显优于DBP SD其他两组,比较差异均有统计学意义(P<0.01)。在(180±3)d时,24 h SBP SD<25 mm Hg组的NIHSS及ADL评分均明显优于24 h SBP SD≥50 mm Hg组,24 h DBP SD<15 mm Hg组均明显优于DBP SD其他两组,且15 mm Hg≤24 h DBP SD<30 mm Hg组均明显优于24 h DBP SD≥30 mm Hg组,差异均有统计学意义(P<0.01);25 mm Hg≤24 h SBP SD<50 mm Hg组的ADL评分明显优于24 h SBP SD≥50 mm Hg组,差异有统计学意义(P<0.01)。结论:应重视缺血性脑卒中急性期患者,特别是具有较多合并症且舒张压24 h波动大于30 mm Hg患者血压变异性的调节,降低血压波动以改善患者预后。Objective：To study the correlation of blood pressure variability and prognosis in patients with acute phase of ischemic stroke.Method：Ninety patients admitted to the emergency department of the second Chinese medicine hospital in Shenyang city from January 2014 to June 2015 were selected as the research objects and divided into 3 groups according to the deviation of systolic blood pressure in 24 h and 3 groups according to the deviation of diastolic blood pressure in 24 h respectively,then they were given conventional therapy.The change of NIHSS and ADL scores were analyzed by statistical software（30±1）days,（90±2）days and（180±3）days after the treatment.Result：At（30±1）days after the treatment,the NIHSS and ADL score in 24 h SBP SD〈25 mm Hg group were significantly better than other two SBP SD groups,the 25 mm Hg≤24 h SBP SD〈50 mm Hg group were significantly better than those of 24 h SBP≥50 mm Hg group,and the 24 h DBP SD〈15 mm Hg group were significantly better than which of other two DBP SD groups,the differences were statistically significant（P〈0.05 or P〈0.01）.At（90±2）days after the treatment,the NIHSS and ADL scores in 24 h SBP SD〈25 mm Hg group were significantly better than which of the 25 mm Hg≤24 h SBP SD〈50 mm Hg group,the 15 mm Hg≤24 h DBP SD〈30 mm Hg group were significantly better than the 24 h DBP SD≥30 mm Hg group,the differences were statistically significant（P〈0.05）.While those of the 24 h SBP SD〈25 mm Hg group were significantly better than the 24 h SBP≥50 mm Hg group and those of the 24 h DBP SD〈15 mm Hg group were significantly better than other two DBP SD groups,the differences were statistically significant（P〈0.01）.At（180±3）days after the treatment,the NIHSS and ADL scores in 24 h SBP SD〈25 mm Hg group were significantly better than which of the 24 h SBP≥50 mm Hg group,those of 24 h DBP SD〈15 mm Hg group were significantly better than other two DBP SD groups,those of 15 mm Hg≤24 h DBP SD〈30 mm Hg group

关 键 词：急诊室 脑卒中 急性期 血压变异性 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]