缺血性脑卒中伴高血压患者血压控制状况调查

Control of blood pressure in ischemic stroke patients with hypertension

目的了解缺血性脑卒中患者血压控制及降血压药物使用情况,分析影响降压药物使用的因素。方法选择2014年1-12月连续收住我院神经内科病房的住院且确诊为缺血性脑卒中和短暂性脑缺血发作患者总计740例,将360例复发性脑卒中纳入分析,高血压314例（87.2%）,糖尿病142例,对入选患者血压控制及降血压药物使用情况进行调查。结果 314例高血压患者中,血压达标率为28.3%;142例糖尿病患者中,血压达标率为9.2%。314例高血压患者,服用任1种抗高血压药物248例,药物治疗率79.0%,有21.0%未服用任何降压药物。2型糖尿病、冠心病、吸烟、饮酒、服用抗血小板药物与降压药物治疗有关（P〈0.05）。冠心病（OR=0.275,95%CI：0.094-0.804,P=0.018）及服用抗血小板药物（OR=0.547,95%CI：0.310-0.966,P=0.038）是影响患者降压治疗的独立危险因素。结论缺血性脑卒中患者血压控制达标率与指南要求存在差距,伴糖尿病患者血压控制达标率更不理想,应加强脑卒中患者血压控制。

Objective To analyze the factors influencing the use of hypotensors in ischemic stroke patients.Methods Of the 740 ischemic stroke and TIA patients admitted to our hospital from January 2014 to December 2014,360 recurrent ischemic stroke patients including 314（87.2%）with hypertension were included in this study.The control of blood pressure and the use of hypotensors in these patients were investigated.Results The normal blood pressure was achieved in89（28.3%）out of the 314 ischemic stroke patients with hypertension,and in 13（9.2%）out of the 314 ischemic stroke patients with diabetes mellitus（DM）.Of the 314 ischemic stroke patients with DM,248（79.0%）were treated with a single hypertensor,66（21.0%）did not receive any hypertensor treatment.History of type 2DM,coronary heart disease（CHD）,smoking,alcoholconsumption,and use of anti-platelet drugs was related with hypotensor treatment（P〈0.05）.CHD and use of anti-platelet drugs were the independent risk factors for hypotensor treatment（OR=0.275,95%CI：0.094-0.804,P=0.018;OR=0.547,95%CI：0.310-0.966,P=0.038）.Conclusion The control of blood pressure does not meet the requirement of its clinical guidelines in ischemic stroke patients,especially in those with DM,it is thus necessary to strengthen the control of blood pressure in ischemic stroke patients.