急性脑梗死血管内治疗术前血压与预后的相关性分析  

作　　者：张雨瑶 阮婕[2] 殷聪国 刘克勤 蒋琳[3] 李凌菲 夏文卿 

机构地区：[1]浙江中医药大学第四临床医学院,310053 [2]浙江大学医学院附属第一医院,310003 [3]浙江大学医学院附属杭州市第一人民医院,310003

出　　处：《浙江临床医学》2023年第1期58-60,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨急性前循环大动脉闭塞性脑梗死血管内治疗术前血压的各项参数与临床预后的相关性。方法选取2015年10月至2018年8月血管内介入治疗的急性前循环大动脉闭塞性脑梗死患者215例,记录其年龄、性别、病史、术前美国国立卫生研究院卒中量表(NIHSS)评分等基线资料,测量其动脉穿刺前末次血压;并在术后90 d对患者进行随访,记录改良Rankin量表(mRS)评分,根据mRS评分将患者分为预后良好组(mRS评分0~2分)、预后不良组(3~6分)。分析急性前循环大动脉闭塞性脑梗死术前血压的各项参数与预后的相关性。结果215例急性前循环大动脉闭塞性脑梗死患者中,预后良好组102例,预后不良组113例。预后不良组患者术前收缩压、舒张压、平均动脉压高于预后良好组(P<0.05)。二元Logistic回归分析提示术前收缩压、舒张压、平均动脉压的升高,与急性前循环大动脉闭塞性脑梗死患者不良预后相关(SBP:aOR=1.181,95%CI:1.033~0.0350,P=0.015;DBP:aOR=1.332,95%CI:1.042~1.703,P=0.022;MAP:aOR=1.163,95%CI:1.041~1.300,P=0.08)。结论术前较高的血压水平可能对急性前循环大动脉闭塞性脑梗死不良预后具有预测作用。Objective To explore the relationship between pre-procedural blood pressure parameters and outcome of endovascular treatment in patients with acute anterior circulation large vessel occlusion stroke.Methods A total of 215 patients with acute anterior circulation large vessel occlusion stroke who underwent endovascular treatment in Hangzhou First Hospital,Zhejiang University School of Medical were included from October 2015 to August 2018.The baseline data was collected such as age,gender,medical history and the baseline National Institutes of the Health Stroke Scale(NIHSS)score,and the last blood pressure before artery puncture was measured.After 90 days follow up,patients were divided into two groups and the modified Rankin Scale(mRS)score was recorded.According to the mRS score,the patients were divided into the good prognosis group(mRS score 0-2 points)and the poor prognosis group(3-6 points).The correlation between the pre-procedural blood pressure parameters and functional outcome was analyzed.Results Among 215 patients included,102 of them achieved the favorable functional outcome,113 of them did not.The poor outcome group had the higher pre-procedural blood pressure,including systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),with statistical significance(P<0.05).And the result of the binary Logistic regression indicated that the elevation of the pre-procedural blood pressure(SBP,DBP and MAP)correlated with poor functional outcome of patients with acute anterior circulation large vessel occlusion stroke.(SBP:AOR=1.181,95%CI:1.033~0.0350,P=0.015.DBP:AOR=1.332,95%CI:1.042~1.703,P=0.022.MAP:AOR=1.163,95%CI:1.041~1.300,P=0.08).Conclusion The high pre-procedural blood pressure may have a predictive effect on poor functional outcome of endovascular treatment in patients with acute anterior circulation large vessel occlusion stroke.

关 键 词：急性脑梗死 血管内治疗 术前血压 预后 

分 类 号：R54[医药卫生—心血管疾病]