血压变异性可能是缺血性脑卒中发生及预后的新预测因子  

Blood Pressure Variability May Be a New Predictor for the Occurrence and Prognosis of Ischemic Stroke

作　　者：严克琼 吴绮思[1] 杨军[1] Ke-Qiong Yan;Qi-Si Wu;Jun Yang(Department of Neurology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆400000

出　　处：《Chinese Medical Sciences Journal》2023年第3期242-249,I0008,共9页中国医学科学杂志（英文版）

基　　金：重庆市自然科学基金(csct2020jcy-msxmX0765)。

摘　　要：尽管近年来发病率和死亡率有所下降,但缺血性脑卒中(ischemic stroke,IS)仍然是脑血管疾病致死、致残的主要原因之一。干预可控性危险因素是临床管理IS的基础。高血压是IS最常见的可治疗危险因素之一,并与不良结局有关。动态血压监测结果显示高血压患者的血压变异性(blood pressure variability,BPV)高于非高血压患者。同时,BPV升高已被证明是IS的危险因素。BPV越高,IS发生的风险越高,卒中后的预后越差,无论是在急性期还是亚急性期。BPV受多因素影响,其变化反映了个体的生理病理改变。本文综述了目前BPV与IS关系的研究进展,旨在提高临床医生和IS患者对BPV的认识,探讨BPV升高是IS的可控危险因素。对于高血压患者,不仅需要控制血压平均水平,同时需要关注血压变异性,以更好地开展个性化血压管理。Despite declines in morbidity and mortality in recent years,ischemic stroke(IS)remains one of the leading causes of death and disability from cerebrovascular diseases.Addressing the controllable risk factors underpins the successful clinical management of IS.Hypertension is one of the most common treatable risk factors for IS and is associated with poor outcomes.Ambulatory blood pressure monitoring has revealed that patients with hypertension have a higher incidence of blood pressure variability(BPV)than those without hypertension.Meanwhile,increased BPV has been identified as a risk factor for IS.The risk of IS is higher and the prognosis after infarction is worse with higher BPV,no matter in the acute or subacute phase.BPV is multifactorial,with alterations reflecting individual physiological and pathological changes.This article reviews the current research advances in the relationship between BPV and IS,with an attempt to raise awareness of BPV among clinicians and IS patients,explore the increased BPV as a controllable risk factor for IS,and encourage hypertensive patients to control not only average blood pressure but also BPV and implement personalized blood pressure management.

关 键 词：血压变异性 高血压 缺血性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]