血压监测及降压干预对急性脑梗死静脉溶栓患者预后的影响

Effects of Blood Pressure Monitoring and Intervention on Prognosis of Patients with Acute Cerebral Infarction undergoing Intravenous Thrombolysis

目的:探讨血压监测及降压干预对急性脑梗死静脉溶栓患者预后的影响。方法:90例急性脑梗死患者均分为对照组与观察组,对照组患者常规溶栓及营养等治疗,观察组在对照组患者治疗的基础上给予血压监测及降压干预,2组患者均随访3个月;比较2组患者治疗前及治疗第7天时血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平,于治疗前及治疗后第1、3及5天时,采用美国国立卫生研究院卒中量表(NIHSS)评分评估2组患者的神经功能;治疗后第30天时,采用改良Rankin量表(mRS)评分评估2组患者的神经功能恢复情况,比较随访期间2组患者的出血发生率。结果:治疗前,2组患者血清IL-6、IL-8、TNF-α水平及NIHSS评分比较,差异无统计学意义(P>0.05);2组患者治疗第7天时血清IL-6、IL-8及TNF-α水平均较治疗前降低,观察组低于对照组,差异有统计学意义(P<0.05);2组患者治疗后各时间点NIHSS评分较治疗前降低,观察组低于同时点对照组,差异有统计学意义(P<0.05);治疗后第30天时,观察组患者mRS评分中轻度残障人数高于对照组、重度残障人数低于对照组,差异有统计学意义(P<0.05);2组患者治疗期间的出血发生率比较,差异无统计学意义(P>0.05)。结论:血压监测及降压干预可改善急性脑梗死患者静脉溶栓后NIHSS及mRS评分。

Objective:To investigate the effects of blood pressure monitoring and intervention on the prognosis of patients with acute cerebral infarction undergoing intravenous thrombolysis.Methods:90 patients with acute cerebral infarction were selected and divided into control group and observation group with equal number.Both groups were treated with intravenous thrombolysis and nutrition therapy,and observation group was given extra blood pressure monitoring and lowering blood pressure intervention;both groups were followed up for 3 months after treatment.Interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)were compared before and after treatment(7 days)in both groups.National Institutes of Health Stroke Scale(NIHSS)was used to assess the neurological function before treatment and on the 1^st,3^rd,5^th day after treatment;modified Rankin scale(mRS)was adopted to evaluate the neurological function recovery on the 30th day after treatment,and the incidence rate of bleeding during follow-up was compared.Results:The levels of IL-6,IL-8 and TNF-α as well as NIHSS scores of both groups before treatment showed no statistical significance(P>0.05).On the 7^th day of treatment,levels of IL-6,IL-8 and TNF-α of both groups were obviously lowered than before treatment,observation group was significantly lower than control group,differences were statistically significant(P<0.05).NIHSS scores of both groups at all recorded time were lower than before treatment,observation group scores were obviously lower than control group at each same recorded time,differences were statistically significant(P<0.05);30 days after treatment,mRS scores of observation showed that number of mildly disabled people were obviously higher than that of control group,number of severely disabled people were obviously lower than that of control group,differences were statistically significant(P<0.05).Comparison of bleeding incidence rate of both groups during treatment showed that differences were not statistically significant(P>0.05).Conclusion:Blood pressure monitoring and intervention can improve the NIHSS score and mRS score of patients with acute cerebral infarction undergoing intravenous thrombolysis.