摘要
目的:探讨随诊间血压变异性对脑卒中复发的影响。方法回顾性分析12所医院进行的西洛他唑和阿司匹林预防脑卒中复发试验中698例患者的每次随诊血压,通过Cox比例风险回归模型,计算随诊间血压变异性对脑卒中复发影响的风险比。结果随诊间收缩压标准差与平均收缩压相关( r=0.282,P=0.000),变异系数与平均收缩压相关( r=0.128,P=0.001);调整平均收缩压后,收缩压标准差 H R:3.641,95% C I:2.368~5.599,收缩压变异系数 H R:3.327,95% C I:2.130~5.195,收缩压独立均值变异(V IM ) H R:3.657,95% C I:2.320~5.763,差异有统计学意义( P=0.000)。平均舒张压 H R:4.149,95% C I:2.381~7.229( P=0.000),舒张压标准差、舒张压变异系数、舒张压V IM差异无统计学意义( P>0.05)。调整平均脉压后,脉压标准差 H R:4.973,95% C I:3.295~7.506,脉压变异系数 HR:6.410,95%:CI:3.898~10.538,差异有统计学意义(P=0.000)。结论随诊间收缩压和脉压变异性均是影响脑卒中复发的因素;但随诊间舒张压变异性不是影响脑卒中复发的因素。
Objective To study the effect of blood pressure (BP) variability during follow-up on re-current ischemic stroke .Methods T he BP of 698 patients undergoing cilostazol and aspirin treat-ment in 12 hospitals for prevention of recurrent ischemic stroke was retrospectively analyzed .The hazard ratio ( H R) for the effect of BP variability during follow-up on recurrent ischemic stroke was calculated according to the Cox proportion risk regression model .Results The SD of SBP and the HR of BP variability were related with the mean SBP during follow-up (r=0 .282 ,P=0.000;r=0 .128 ,P=0 .001) .After adjustment for the mean SBP ,the HR was 3 .641 (95% CI:2.368-5 .599) for the SD of SBP ,3 .327 (95% CI:2 .130 -5 .195) for the variability of SBP , 3.657 (95% CI:2 .320 -5 .763) for the VIM of SBP ,and 4 .149 (95% CI:2 .381 -7 .229) for the mean value of DBP (P=0 .000) .No significant difference was found in the SD ,HR ,and VIM of DBP (P〉 0 .05) .After adjustment for the mean pulse pressure ,the HR was 4 .973 (95% CI:3 .295-7.506) for the SD of pulse pressure and 6 .410 (95% CI:3 .898-10 .538)for the variabili-ty of pulse pressure ( P=0 .000 ) .Conclusion T he variability of SBP and pulse pressure during follow-up is a risk factor for recurrent ischemic stroke .However ,the variability of DBP is not a risk factor for recurrent ischemic stroke .
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2014年第10期1065-1068,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
血压测定
卒中
复发
脑缺血发作
短暂性
动脉粥样硬化
blood pressure determination
stroke
recurrence
ischemic attack,transient
atheroscle-rosis