降压干预时段对急性缺血性脑卒中预后的影响

Effect of Antihypertensive Intervention Period on Prognosis of Acute Ischemic Stroke

目的探究不同降压干预时段对急性缺血性脑卒中预后的影响。方法选取2018年1月至2019年8月中国人民解放军联勤保障部队第九八一医院收治的150例急性缺血性脑卒中患者为研究对象,根据降压干预进行的时段不同分为两组,研究组患者(n=80)采取延迟降压治疗方案,即入院前7 d不进行降压治疗,7 d后接受降压治疗;对照组患者(n=70)则采取早期降压治疗,即入院后立即启动降压治疗。两组患者降压治疗的目标均为血压<140/90 mm Hg。记录对比两组患者治疗前、后的神经功能缺损(NIHSS)评分等情况,并对患者进行3个月的随访,比较两组患者的预后情况以及生存状态。结果研究组与对照组患者治疗后NIHSS评分均较治疗前明显减少(P<0.05),但研究组减少更为显著(P<0.05);研究组预后不良发生率明显低于对照组(P<0.05)。研究组患者缺血事件发生率与死亡率均明显低于对照组患者,差异存在明显的统计学意义(P<0.05)。结论对急性缺血性脑卒中患者进行合理延期降压治疗干预,能明显改善患者的神经功能,因此提示延期降压干预可有效改善急性脑卒中患者的预后。

Objective To explore the effect of different antihypertensive intervention periods on the prognosis of acute ischemic stroke.Methods From January 2018 to August 2019,150 patients with acute ischemic stroke admitted to Chinese People's Liberation Army Joint Service Support Unit 981 Hospital were selected and divided into two groups according to the time of antihypertensive intervention.The patients in the study group(n=80)were treated with delayed antihypertensive treatment,that is,no antihypertensive treatment 7 days before admission and received antihypertensive treatment 7 days later.While patients in the control group(n=70)received early antihypertensive treatment,namely antihypertensive treatment was initiated immediately after admission.The target of antihypertensive treatment in both groups was blood pressure<140/90 mm Hg.The NIHSS scores of the two groups before and after treatment were recorded and compared.The patients were followed up for 3 months.The modified Rankin Scale(mRS)score and survival status of the two groups were compared.Results NIHSS scores of the study group and the control group after treatment were significantly decreased compared with those before treatment(P<0.05),but the decrease in the study group was more significant(P<0.05);the proportion of patients with poor prognosis in the study group was significantly lower than that in the control group(P<0.05).The rates of ischemic events and death were significantly lower in the study group than in the control group(P<0.05).Conclusion Reasonable delayed antihypertensive treatment intervention in patients with acute ischemic stroke can significantly improve the neurological function of patients.Therefore,it is suggested that delayed antihypertensive intervention can effectively improve the prognosis of patients with acute cerebral apoplexy.