随访间血压变异性预测缺血性卒中患者远期卒中复发：前瞻性病例系列研究  

Visit-to-visit blood pressure variability predicts long-term stroke recurrence in patients with ischemic stroke： a prospective case series study

作　　者：郑伟城[1] 石铸[1] 曾淑芳 李淑恩[1] 符小丽[1] Zheng Weicheng, Shi Zhu, Zeng Shufang, Li Shuen, Fu Xiaoli(Department of Neurology, Dongguan People＇s Hospital, Dongguon 523018, Chin)

机构地区：[1]东莞市人民医院神经内科,523018

出　　处：《国际脑血管病杂志》2018年第2期119-123,共5页International Journal of Cerebrovascular Diseases

基　　金：东莞市社会科技发展项目（2016108101002）;广东省医学科学技术研究基金（A2013836）

摘　　要：目的探讨缺血性卒中患者随访问血压变异性与远期卒中复发的相关性。方法连续登记首次发病的急性缺血性卒中患者，记录人口统计学和临床资料。出院后每月进行随访，测量随访问血压并计算其平均值和血压变异性指标。完成12个月随访，记录有无卒中复发事件。单变量分析比较复发组与未复发组人口统计学和临床资料，采用多变量logistic回归分析确定随访问血压变异性与卒中复发的相关性。结果共556例患者完成随访，其中62例（11．2％）复发卒中。复发组随访间收缩压标准差[（16．5±4．7）mmHg对（13．4±4．2）mmHg，1mmHg=0．133kPa；t=1．953，P=0．042]和变异系数[11．9±3．1对9．8±2．4；t=2．287，P=0．001]显著高于非复发组。多变量logistic回归分析显示，随访问血压收缩压变异系数与卒中复发独立相关（优势比1．305，95％可信区间1．004～7．491；P=0．017）。结论随访问血压变异性与缺血性卒中患者远期卒中复发独立相关。Objective To investigate the correlation between visit-to-visit blood pressure variability and long-term stroke recurrence in patients with ischemic stroke. Methods Consecutive patients with first-ever acute ischemic stroke were registered. The demographic and clinical data were documented. The patients were followed up every month after discharge. Visit-to-visit blood pressure was measured, and its mean value and blood pressure variability parameters were calculated. A 12-month follow-up period was completed and the recurrent stroke events were documented. Univariate analysis was used to compare the demographic and clinical data in the recurrent and non-recurrent groups. Multivariate logistic regression analysis was used to identify the correlation between visit-to-visit blood pressure variability and stroke recurrence. Results A total of 556 patients completed the follow-up, including 62 （11.2%） with recurrent stroke. The standard deviation （16. 5 ± 4. 7 mmHg vs. 13.4 ±4.2 mmHg, 1 mmHg = 0. 133 kPa; t = 1. 953, P = 0. 042） and coefficient of variation （11.9 ± 3.1 vs. 9.8 ± 2. 4; t = 2. 287, P = 0. 001） of visit-to-visit systolic blood pressure in the recurrent group were significantly higher than those in the non-recurrent group. Multivariable logistic regression analysis showed that visit-to-visit coefficient of variation of systolic pressure was independently associated with stroke recurrence （odds ratio 1. 305, 95% confidence interval 1. 004-7. 491; P=0.017）. Conclusion The visit-to-visit blood pressure variability was independently associated with long-term stroke recurrence in patients with acute ischemic stroke.

关 键 词：卒中 脑缺血 高血压 血压 复发 危险因素 时间因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]