缺血性脑卒中患者急性期血压水平变化对预后的影响

Observation on the changes of blood pressure in patients with acute ischemic stroke and its effect on the prognosis of them

目的通过观察我院缺血性脑卒中急性期患者的临床资料,探讨分析该疾病患者急性期血压水平变化影响预后情况。方法对我院收治的98例缺血性脑卒中急性期患者,监测血压变化后,进行分组(勺型组、非勺型组、超勺型组、反勺型组),对比分析4组患者一般资料、临床血生化指标以及卒中量表(NIHSS)评分、Barthel指数。结果 98例患者中,勺型组40例,非勺型组28例,超勺型组20例,反勺型组10例,4组患者在年龄、性别、脑卒中类型等一般资料对比差异无统计学意义(P>0.05);4组患者在低密度脂蛋白、三酰甘油以及超敏C反应蛋白水平等指标对比,差异具有统计学意义(P<0.05);勺型组患者入院时与3个月后的NIHSS评分、Barthel指数与其余3组患者相比,差异具有统计学意义(P<0.05),4组患者3个月后的NIHSS评分、Barthel指数分别与入院时相比,差异具有统计学意义(P<0.05)。结论缺血性脑卒中急性期患者往往表现有血压昼夜节律出现异常现象,血压昼夜节律异常影响患者神经功能及生活自理能力等预后情况,值得临床上进一步推广与研究。

Objective To analyze the changes of blood pressure levels during the acute phase of acute ischemic stroke and its effect on the prognosis. Methods Totally 98 cases with acute iscbemic stroke in our hospital, after monitoring blood pres- sure, were divided into four groups （dipper group, non-dipper group,super dipper group, reverse dipper type group）, and gen- eral information, clinical blood biochemical indexes and Stroke Scale （NIHSS） score, Barthel index of four groups were com- pared. Results Among 98 patients, dipper group had 40 cases, non dipper grouphad 28 cases, super dipper group had 20 ca- ses, reverse dipper type group had 10 patients, and four groups had no significant difference in general information such as age, sex, stroke type （P〉0. 05） ; low density lipoprotein, three glycerol and high sensitivity C reactive protein level between four groups had significant difference （P〈0.05）; the NIHSS Barthel index and admission scores after 3 months of dipper group were significantly different with those of other three groups （P（0.05）. After 3 months, NIHSS score, Barthel index of four groups were significantly different with those at admission （P〈0.05）. Conclusion Patients with acute ischemic stroke often have manifestations of circadian rhythm of blood pressure and abnormal, abnormal circadian rhythm of blood pressure may affect the neurological function and self-care ability and prognosis, so it is worthy of further promotion and research.