脉压／平均动脉压比率预测脑出血的可行性研究

The probability of PP/MAP Ratio in predicting cerebral hemorrhage

目的通过对脑出血患者发病时脉压和脉压／平均动脉压比率与对照组的比较，探讨脉压／平均动脉压比率预测脑出血的可行性。方法选取脑出血患者108例，测定入院时的首次血压（不受治疗因素影响），计算其脉压（PP）、脉压／平均动脉压比率（PP／MAPRatio），与年龄、性别匹配的健康对照组102例的PP、PP／MAP Ratio进行比较、分析。结果脑出血组的PP、PP／MAP Ratio显著高于对照组（PP：χ^2=196．000，PP／MAP Ratio：χ^2=249．771，P〈0．01），PP、PP／MAP Ratio分布频率与对照组差异有统计学意义（PP：χ^2=87．469，PP／MAP Ratio：χ^2=18．960，P〈0．01）。全部病例进人Logstic回归分析，PP≥50 mmHg者脑出血发病的危险性是PP低于50mmHg者的5倍（0R=5．000，95％CI为2．642～9．461）；PP／MAP Ratio高于0．45者脑出血是PP／MAP Ratio低于0．45者的2．6倍（0R=2．647，95％CI为1．516～4．622）。PP〉50mmHg、PP／MAP Ratio〉0：45，脑出血的发病率明显增大。结论PP／MAP Ratio也和PP-样都可以用于预测脑出血发病的危险性，PP／MAP Ratio是无量纲值，具有可比性，因此优于PP。

Objective To compare with pulse pressure/mean artery pressure Ratio（PP/MAP Ratio） and pulse pressure（PP） between cerebral hemorrhage and control group. To evaluate the probability of PP/MAP Ratio in predicting cerebral hemorrhage. Methods Blood pressures were measured for 108 cerebral hemorrhage patients,and 102 age-and sex-matched controls respectively. PP and PP/MAP Ratio of every subject were calculated. Mean of PP and PP/MAP Ratio between different groups were compared via Chi-Square non-parametric method. Logistic regress analysis was used in accessing the risk for cerebral hemorrhage. Results PP and PP/MAP Ratio in cerebral hemorrhage cases were significantly higher than control group （PP： χ^2 = 196. 000, PP/MAP Ratio： χ^2 = 249. 771, P 〈 0.01 ）. PP and PP/MAP Ratio distributions in cases were significantly different from control（PP：χ^2 = 87. 469 ,PP/ MAP Ratio： χ^2 = 18. 960, P 〈 0.01 ）. All cases were analyzed by in Logistic regress. Missing cases was 0. According the result of Logistic regress analysis the risk for cerebral hemorrhage and was-five times（OR = 5. 000,95% CI 2. 642 - 9. 461 ） respectively in subjects who had a PP higher or equal to 50 mmHg compared with those who had a PP lower than to 50mmHg. For Participants with a PP/MAP Ratio higher than 0.45, their risks for cerebral hemorrhage was 2.6 times（OR = 2. 647,95 % CI 1. 516-4. 622） respectively as compared with participants who had a PP/MAP ratio lower to 0.45. Conclusion PP/MAP Ratio is more comparable and takes into account all components of blood pressure,therefore may be a better predictor of cerebral hemorrhage.