自发性脑出血急性期血压水平与近期神经功能恢复的相关性

Correlation of blood pressure levels of spontaneous cerebral hemorrhage during acute phase and recent neural functional recovery

目的分析自发性脑出血急性期血压水平与近期神经功能恢复的相关性,比较以不同分界血压分组的各组患者神经功能恢复情况,探讨最优血压控制目标。方法选取2012年8月至2013年9月收治的76例自发性脑出血急性期患者,密切观察患者急性脑出血期间的血压变化情况,采用美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评价神经功能状况,比较在不同血压水平条件下患者NIHSS评分情况。结果患者入院28天后的收缩压与患者近期神经功能NIHSS评分恢复密切相关(r=-0.239,P=0.026),以收缩压160 mmHg为临界值分组,对比发现收缩压≤160 mm Hg的患者近期(入院第28天)神经功能NIHSS评分明显比收缩压>160 mm Hg的患者恢复快(P<0.01),而以140 mm Hg收缩压及以150 mm Hg收缩压为临界值分组对比,患者近期(入院第28天)神经功能NIHSS评分比较,差异均无统计学意义(P>0.05)。结论自发性急性脑出血期的血压水平与近期神经功能恢复存在密切相关性,控制患者的收缩压≤160 mm Hg,可能是较为合理的血压控制方案。

Objective To analyse correlation of blood pressure levels of spontaneous cerebral hemorrhage during acute phase and recent neural functional recovery, so as to compare neural functional recovery of patients in groups divided accord- ing to different pressure levels, and to investigate the optimal target for blood pressure. Methods 76 cases of spontaneous cerebral hemorrhage during acute phase admitted to hospital from August, 2012 to September, 2013 were enrolled in this stud- y.Changes of their blood pressure during acute cerebral hemorrhage were closely observed.National Institute of Health Stroke Scale （NIHSS） was used to evaluate patients＇neurological function status.And patients＇ NIHSS score under the condition of different blood pressure levels were compared. Results 28 days after admission, patients＇ systolic blood pressure was closely related to NIHSS scores of recent neurological function （r=-0.239 ,P= 0.026）.When systolic blood pressure 160 mmHg was taken as the threshold of grouping, the comparison showed that NIHSS scores of recent neurological function （ on the 28th day of admission） of patients with systolic blood pressure ~〈 160 mmHg recovered more quickly than that of patients with systolic blood pressure〉 160 mmHg （P〈0.01）.While systolic blood pressure 140 mmHg and 150 mmHg were taken as the threshold of grouping, difference of NIHSS scores of recent neurological function （ on the 28th day of admission） was not statistically significant （P〉0.05）.Conclusion Blood pressure of spontaneous cerebral hemorrhage during acute phase is closely related to recent neurological function recovery.And to control patients＇systolic blood pressure ≤ 160 mmHg may be relatively reason- able for blood pressure control scheme.