H型高血压与急性脑梗死患者预后的关系研究

The Correlation of H Type Hypertension and Prognosis of Patients with Acute Cerebral Infarction

目的探讨H型高血压与急性脑梗死患者预后的关系。方法选择于2010年1月—2012年1月在我院住院的急性脑梗死合并高血压患者324例,根据血浆同型半胱氨酸(Hcy)水平将其分为H型高血压组(Hcy≥10μmol/L)241例与对照组(Hcy<10μmol/L)83例。观察两组患者的临床特征,并随访至出院后90 d,采用美国国立卫生研究院卒中量表(NIHSS)、日常生活活动能力量表(BI)及改良Rankin量表(mRS)评估患者入院时及出院后90 d的神经功能缺损与预后情况。结果两组患者的年龄、性别、收缩压水平、糖尿病史、吸烟史、高脂血症史,入院时的血脂、血糖、D二聚体(D-Dimer)、高敏C-反应蛋白(hs-CRP)水平及90 d病死率间差异均无统计学意义(P>0.05)。与对照组相比,H型高血压组患者入院及90 d时的NIHSS评分升高,BI评分及mRS评分为0～2分的比例降低,两组间差异有统计学意义(P<0.05)。Logistic回归分析结果显示,H型高血压是急性脑梗死预后不良的独立危险因素〔OR=2.447,95%CI(1.878,5.248),P=0.027〕。结论合并H型高血压的急性脑梗死患者神经功能缺损更严重,预后不良。

Objective To investigate the correlation of H type hypertension with prognosis of patients with acute cere- bral infarction （ACI） . Methods A total of 324 ACI patients with hypertension admitted in our hospital between January 2010 and January 2012 were enrolled in this study. The patients were divided into the H type hypertension group （Hey≥10μmol/L; n = 241 ） and the control group （ Hey 〈 10μmol/L; n = 83 ） according to the level of homoeysteine （Hey） measured upon admis- sion. The clinical characteristics of the patients were compared between the two groups. National institute of health stroke scale （ NIHSS）, Barthel index （ BI）, and modified Rankin scale （mRS） were used to evaluate the functional disability and prognosis of patients upon admission and at 90 days after discharge. Results No significance was found between the two groups in age, sex, systolic blood pressure, history of diabetes, smoking, and hyperlipemia, as well as the level of blood fat, blood glucose, D - Dimer, and hs - CRP upon admission and mortality at 90 days （ P 〉 0. 05 ） . H type hypertension group had higher NIHSS score, lower BI score, and lower proportion of 0 - 2 scoring in mRS than the control group both on admission and at 90 days （P 〈 0.05 ）. Logistic analysis results showed that H type hypertension [ OR = 2. 447, 95% （31 （ 1. 878, 5. 248 ）, P = 0. 027 ] was an independent risk factor for poor prognosis of ACI. Conclusion ACI patients with H type hypertension have serious neurologi- cal dysfunction and poor diagnosis.