脑卒中急性期血压的变化规律及肢体运动前后血压变化

The regularity of blood pressure changes in patients with acute stroke and the amplitude of blood pressure changes after extremities exercises

目的:监测脑卒中急性期患者血压变化规律,观察急性脑梗死患者肢体运动前后血压变化的幅度。方法:随机选择脑卒中急性期患者148例,分为两组,其中,脑梗死组102例,脑出血组46例。观察急性期两组患者的血压变化,测量102例急性脑梗死患者右侧肱动脉血压,床边肢体松动运动前测量1次,运动后即5、10、15min各测量1次。结果:脑卒中急性期血压增高者占86.5%,以后在无特殊降压措施并且不用对血压有影响的药物条件下,血压随时间逐渐下降。第7天与第1天比较,收缩压(SBP)及舒张压(DBP)均有明显下降[SBP(145.6±16.3)vs(157.1±22.5)mmHg(P<0.01);DBP(84.7±15.2)vs(89.8±21.2)mmHg(P<0.01)];脑出血组动态血压均高于脑梗死组。[SBP(159.7±19.8)vs(154.7±23.4)mmHg;DBP(96.2±13.1)vs(91.3±17.5)mmHg(P<0.01)]。86%的脑卒中患者血压的昼夜节律消失。脑梗死组床边肢体松动运动前后血压比较,差异无显著性(P>0.05)。结论:脑梗死急性期患者血压增高,血压有自发下降的趋势;脑出血患者血压水平比脑梗死者高;绝大多数脑卒中患者血压的昼夜节律消失;脑梗死患者床边肢体松动运动前后的血压比较差异无显著性。

Objective： To monitor the regularity of blood pressure changes in patients with stroke at acute stage, and the amplitude of blood pressure changes after extremities exercises. Method： One hundred and forty-eight patients with stroke at acute stage were divided into two groups： cerebral infarction group （n=102） and cerebral hemorrhage group （n=46）. Blood pressure of patients in both groups were monitored. The right brachial artery blood pressure of patients in cerebral infarction group was measured before and after extremities relaxation exercises. Result： ① Blood pressure elevated in 86.5% of patients with stroke at acute stage and then descended spontaneously. Compared with that of the 1st day after onset, blood pressure descended significantly from [SBP （157.1±22.5）,DBP（89.8±21.2）mmHg] to [SBP（145.6±16.3）,DBP（84.7±15.2）mmHg,（P〈0.01）] on the 7th day. ②Dynamic blood pressure were higher in cerebral hemorrhage group compared with cerebral infarction group [SBP （159.7±19.8） vs （154.7±23.4）mmHg. DBP（96.2±13.1） vs （91.3±17.5）mmHg（P〈0.01）]. ③Among 86% of subjects, circadian rhythm of blood pressure was missing. ④There was no significant different in blood pressure before and after extremities relaxation exercises in patients with acute cerebral infarction （P〉0.05）. Conclusion： ①Blood pressure elevated in patients with cerebral infarction at acute stage and then showed a tendency of descending spontaneously. ②The level of blood pressure in cerebral hemorrhage group was higher than that in cerebral infarction group. ③Normal circadian rhythm of blood pressure was lost in most of patients with stroke. ④There was no significant different in blood pressure before and after extremities relaxation exercises in patients with acute cerebral infarction.