高血压治疗与缺血性脑卒中严重程度相关性分析

Correlation of previous treatment of hypertension with the severity of ischemic stroke

目的高血压是心脑血管疾病首要的可控危险因素,而很多高血压患者对治疗高血压的态度并不积极。文中探讨既往高血压治疗情况与缺血性脑卒中严重程度之间的关系,以期为卒中的预防提供参考。方法回顾性分析2011年1月至2014年12月在南京军区南京总医院神经内科住院的653例首发48 h内缺血性脑卒中合并高血压患者的临床资料,根据入院时神经功能缺损评分（National Institute of Health Stroke Scale,NIHSS）将卒中分为轻型（NIHSS≤3）和重型（NIHSS〉3）2组。同时根据既往高血压治疗情况将所有患者分为4组,包括规律治疗组、不规律治疗组、不治疗组及高血压不知情组。Spearman相关分析法用来分析既往高血压的治疗情况与缺血性脑卒中的严重程度之间相关性。多因素Logistic回归用来分析与缺血性脑卒中严重程度相关的影响因素。结果入院时神经功能缺损程度与患者既往高血压治疗情况呈正相关（r=0.146,P=0.000 2）;既往高血压不规律治疗（OR=2.21,95%CI：1.39-3.52,P=0.001）、不治疗（OR=2.18,95%CI：1.41-3.36,P=0.000 4）及不知情（OR=1.80,95%CI：1.12-2.88,P=0.015）的患者相比于高血压规律治疗的患者更倾向于患重型缺血性卒中。结论既往高血压治疗水平与缺血性脑卒中的神经功能缺损程度相关。

Objective Hypertension is a leading modifiable risk factor for cardiovascular disease. However,a lot of hypertension patients hold inactive attitudes to hypertension treatment. The purpose of this study was to investigate the relationship between previous treatment of hypertension and stroke severity in acute ischemic stroke. Methods We retrospectively analyzed the clinical data of 653 in-hospital ischemic stroke patients with hypertension between January 2011 and December 2014. According to the National Institutes of Health Stroke Scale（ NIHSS） at admission,the stroke patients were divided into a mild group（ NIHSS ≤ 3） and a severe group（ NIHSS 3） and,based on their history of hypertension treatment,allocated to a regular treatment,an irregular treatment,a non-treatment,and an unawareness group. We studied the relationship of previous hypertension treatment with stroke severity by Spearman correlation analysis and identified the potential factors associated with stroke severity by multivariate logistic regression analysis. Results Previous treatment of hypertension was positively correlated with stroke severity（ r = 0. 146,P = 0. 000 2）. Compared with the patients of the regular treatment group,those in the irregular treatment group（ OR： 2. 21; 95% CI： 1. 39- 3. 52; P = 0. 001）,non-treatment group（ OR： 2. 18; 95% CI： 1. 41- 3. 36; P =0. 000 4） and unawareness group（ OR： 1. 80; 95% CI： 1. 12- 2. 88; P = 0. 015） tended to have more severe stroke. Conclusion Previous treatment of hypertension is closely related to the severity of ischemic stroke.