脑卒中患者急性期动态脉压和脉压指数与近期预后的关系

The relationship between ambulatory pulse pressure and pulse pressure index and prognosis in stroke patients

目的 探讨脑卒中患者急性期动态脉压 (PP)和脉压指数 (PPI)的变化及与近期预后的关系。方法 利用动态血压监测 (ABPM )手段 ,测定 76例脑卒中患者急性期 2 4hABPM变化 ,与 45例健康人ABPM值做对比 ,并在患者入院第 1 5天做神经功能缺损程度评分。结果 脑卒中患者急性期 2 4h平均PP(2 4hPP)、2 4h平均PPI(2 4hPPI)均高于对照组 (P <0 0 5)。其中 ,重度神经功能缺损者 2 4hPP、2 4hPPI均高于轻度和中度患者 (P <0 0 5)。中度患者 2 4hPPI高于轻度患者 (P <0 0 5) ,2 4hPP差异无显著 (P >0 0 5)。 2 4hPP与神经功能缺损评分间呈弱的正相关(P <0 0 5) ,2 4hPPI与评分间呈强的正相关 (P <0 0 1 )。结论 脑卒中患者急性期PP和PPI发生异常 ,并对预后的判断有一定的指导意义。

Objective To explore the relationship of the change of ambulatory blood pressure (PP) and pulse pressure index (PPI) with prognosis in stroke patients.Methods 24 h ambulatory blood pressure was measured in 76 patients with stroke and 45 controls with ambulatory blood pressure measure (ABPM). Results In stroke patients, 24 h mean ambulatory PP (24 h PP) and 24 h mean PPI (24 h PPI) were higher than those of controls ( P <0.05). 24 h PP and 24 h PPI in grade Ⅲ of SSS were higher than those in grade Ⅰand grade Ⅱ ( P <0.05). Compared with grade Ⅰ, 24 h PPI were higher in grade Ⅱ, which were not seen in 24 h PP ( P >0.05). The relationship between 24 h PP and SSS scores was positive weakly ( P <0.05), strongly positive with SSS score ( P <0.01). Conclusions The changes of ambulatory PP and PPI may play important role in the prognosis of stroke patients.