老年缺血性脑卒中急性期血压与预后的关系  

Relationship between blood pressure at acute stage and prognosis in elderly patients with acute ischemic stroke

作　　者：蒋建平[1] 陈红 张磊[2] 彭朝明[2] 谭志强 王欢 王沛坚[2] JIANG Jian-ping;CHEN Hong;ZHANG Lei;PENG Chao-ming;TAN Zhi-qiang;WANG Huan;WANG Pei-jian(Department of Neruology,Pengzhou People's Hospital,Chengdu 611930,China;Department of Geriatrics,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]彭州市人民医院神经内科,四川省成都市611930 [2]成都医学院第一附属医院老年医学科,四川省成都市610500

出　　处：《实用老年医学》2020年第2期163-166,170,共5页Practical Geriatrics

基　　金：国家自然科学基金资助项目(81500393)

摘　　要：目的分析老年缺血性脑卒中(EIS)急性期血压与预后的关系。方法采用回顾性研究方法,选择2016年7月至2018年7月发病24 h内的EIS病人598例,收集入院时及入院后10 d内血压,随访出院后1个月及6个月的死亡、残疾情况。采用多因素Logistic回归分析血压与预后的关系。结果入院血压在140/80 mmHg左右,第1~7天每日平均血压在150/85 mmHg左右的病人有较好预后。血压与预后表现为U型关系。卒中后1个月死亡的独立影响因素为入院24 h内血压降低程度,卒中后6个月死亡或残疾的独立影响因素是第3天和第5天的DBP及第7天的SBP。结论EIS急性期的血压水平是预后独立影响因素,入院1周内血压的调控异于常规水平。Objective To analyze the relationship between blood pressure at acute stage and prognosis in elderly patients(≥65 years old)with acute ischemic stroke(EIS).Methods A retrospective study was conducted on 598 cases of EIS within 24 hours from onset who were admitted to our hospital from July 2016 to July 2018.Blood pressure was detected at admission and within 10 days after admission,death and disability were recorded 1 month and 6 months after discharge.Multivariate Logistic regression was used to analyze the relationship between blood pressure and prognosis.Results The patients with an admission blood pressure of 140/80 mmHg,and an average blood pressure from the first day to seventh day of 150/85mmHg presented with a good prognosis.Blood pressure and prognosis showed U-type relation.The independent risk factors for death 1 month after stroke was the degree of decrease in blood pressure within 24 h after admission.The independent risk factors for death or disability 6 months after stroke were the diastolic blood pressure on the third and fifth day and the systolic pressure on the seventh day.Conclusions Blood pressure at acute stage of EIS may independently affect the prognosis.It is important to regulate and contol the blood pressure within 1 week after admission.

关 键 词：老年人 缺血性脑卒中 血压 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]