急性脑卒中患者入院时脉压水平与住院期间死亡、残疾危险

Pulse Pressure and the In-Hospital Mortality and Morbidity in Acute Stroke Patients

目的研究脑卒中急性期患者入院时脉压与其住院期间死亡、残疾危险性之间的关系。方法对2003-01—2005-12期间内蒙古通辽市6家医院的3938例脑卒中患者,进行血压的测量以及其他基线资料的收集,采用 logistic 回归进行统计分析。结果在出血性脑卒中患者中,与脉压<50 mmHg 组相比,调整了年龄、性别、民族、吸烟、饮酒等因素后,脉压50～69 mmHg 组和脉压≥70 mmHg 组的死亡的 OR 值分别为1.144(95%CI 0.483～2.710,P>0.05)和1.878(95%CI 0.835～4.220,P>0.05,都没有显著差异),残疾的 OR 值分别为1.275(95%CI 0.917～1.773,P>0.05)和1.464(95%CI 1.061～2.020,P=0.02)。而在缺血性脑卒中患者中,各脉压组的死亡和残疾的 OR 均无显著性意义。结论出血性脑卒中急性期患者入院时脉压值≥70 mmHg 者,发生残疾的危险性越大。

Objective To investigate the relationship between pulse pressure during admission and the risk of in-hospital mortality and morbidity in acute stroke patients. Methods Three thousand nine hundred and thirtyeight acute stroke patients in six hospitals in Tongliao city, Inner Mongolia, were enrolled from January, 2003 to December, 2005. The relationship between admission pulse pressure（PP） and the risk of in-hospital mortality and morbidity in acute stroke patients were evaluated by using multiple logistic model. Results Compared with PP（ 50 mmHg, the ORs of in-hospital morbidity in patients with PP 50 69 mmHg or ≥70 mmHg were 1. 144（95% CI, 0. 483--2. 710） and 1. 878（95% CI, O. 835--4. 220, P〉0.05）, respectively, ORs of in-hospital morbidity in PP 50--69 mmHg andS70 mmHg were 1.275（95%CI, 0.917 1.773, P〉0.05）and 1.464（95% CI 1.061 2. 020, P=0. 027, respectively in hemorrhagic stroke patients after adjustment for age, gender, ethnicity, cigarette smoking and alcohol drinking. However, the ORs of mortality and morbidity were not significant in various pulse pressure groups in ischemic stroke patients. Conclusion The elevated pulse pressure was associated with increased risk of in-hospital morbidity only in hemorrhagic stroke patients.