脑梗死急性期降压治疗对近期预后的影响

Influence of antihypertensive treatment during the acute period on recent prognosis of cerebral infarction

目的观察脑梗死急性期降压治疗对近期预后的影响。方法 143例脑梗死患者根据急性期对血压的干预与否分为干预组(52例)和对照组(91例);两组在脑梗死常规治疗的基础上,干预组和对照组分别于入院次日起及第7 d起给予降压治疗。记录两组患者入院14 d内的每日血压变化,入院第1、2、7、14 d给予美国国立卫生研究院卒中量表(NIHSS)评分及入院第7、14 d给予改良Rankin量表(mRS)评分;比较两组入院7及14 d心脑血管事件再发生率及近期预后。结果干预组入院第6 d时、对照组第14 d时血压降至正常水平;与对照组比较,入院14 d时干预组NIHSS评分明显降低(P<0.05);入院7、14 d内心脑血管事件再发率明显降低(均P<0.05);入院14 d内死亡/残疾率明显降低(P<0.05)。结论脑梗死急性期合理降压治疗可改善患者的近期预后。

Objective To observe the influence of antihypertensive treatment during the acute period on recent prognosis of cerebral infarction（CI）. Methods One hundred and forty-three acute CI patients were randomly divided into the antihypertensive group （52 cases） and the control group （91 cases）. On the basis of CI conventional treatment in the two groups, the antihypertensive group and control group were treated with hypotensive drugs since 2nd d and 7th d after admission respectively. The daily blood pressure change of the patients in the two groups was observed in 14 d after admission. The scores of National Institutes of Health Stroke Scale （NIHSS） was measured at 1 , 2, 7 and 14 d after admission, the modified Rankin Score （mRS）was measured at 7 and 14 d after admission. The recurrent rate of cardiovascular and cerebrovascular event and recent prognosis were recorded at the 14 d after admission. Results Hypertension returned to normal in the antihypertensive treatment group at the 6th d and in the control group at the 14th d after admission. Compared with the control group, the NIHSS score in the antihypertensive group was significantly decreased at the 14th d after admission （ all P 〈 0. 05 ） ; The recurrent rate of cardiovascular and cerebrovascular event were significantly reduced at the 7th and 14th d after admission （all P 〈 0. 05 ） ; the rate of death/disability was significantly reduced at 14 d after admission （ all P 〈 0. 05 ）. Conclusion The reasonable antihypertensive therapy in the acute period can improve recent prognosis of CI patients.