收缩压变异与蛛网膜下腔出血急性期血肿扩大的相关性分析

Correlation analysis of systolic blood pressure variation and hematoma expansion in acute phase of subarachnoid hemorrhage

目的分析收缩压变异与蛛网膜下腔出血急性期血肿扩大的相关性。方法选取舞阳县中心医院2019年至2021年收治的蛛网膜下腔出血患者124例,按照24 h血肿扩大与否分为扩大组40例与未扩大组84例,于入院时及24 h后行头部CT血肿三维重建,通过平均血压、收缩压(SBP)标准差(SD)、变异系数(CV)、连续变异度(SV)对患者血压变异情况进行比较分析,二元Logistic回归分析收缩压变异与血肿扩大的相关性。结果两组患者高血压病、入院前抗凝抗血小板药物使用、入院24 h后血肿体积、血肿体积改变绝对值、血肿体积变化率和Hunt-Hess分级比较差异有统计学意义(P<0.05)。血肿扩大组入院SBP、24 h平均SBP、夜间SBP均显著高于未扩大组(P<0.05),血肿扩大组SBP昼夜差显著低于未扩大组(P<0.05),血肿扩大组血压晨峰、SBP-SD、SBP-CV、SBP-SV均显著高于未扩大组(P<0.05)。Logistic回归显示SBP-SD、SBP-CV和SBP-SV与患者24 h血肿扩大之间存在高度相关。结论收缩压变异对蛛网膜下腔出血急性期血肿扩大有一定的预测及评估作用。

【Objective】To analyze the correlation between systolic blood pressure variation and hematoma expansion in the acute phase of subarachnoid hemorrhage.【Methods】A total of 124 patients with subarachnoid hemorrhage admitted from 2019 to 2021 were selected.According to whether the 24-hour hematoma was enlarged or not,they were divided into 40 patients in the enlarged group and 84 patients in the unenlarged group.Three-dimensional reconstruction of the head CT hematoma was performed on admission and 24 hours later.Mean blood pressure,standard deviation of systolic and diastolic blood pressure(SD),coefficient of variation(CV),successive variation(SV)were used to compare and analyze the blood pressure variability of patients.Binary Logistic regression was adopt to analyze the correlation between systolic blood pressure variation and hematoma enlargement.【Results】The hypertension,the use of anticoagulant and antiplatelet drugs before admission,the hematoma volume 24 hours after admission,the absolute value of the hematoma volume change,the hematoma volume change rate and the Hunt-Hess classification were statistically different between the two groups(P<0.05).The SBP,24-hour average SBP,and night SBP in the enlarged hematoma group were significantly higher than those in the unenlarged group(P<0.05).The SBP difference between day and night in the enlarged hematoma group was significantly lower than that in the unenlarged group(P<0.05).Morning blood pressure peak,SBP-SD,SBP-CV,and SBP-SV in the enlarged group were significantly higher than those in the unenlarged group(P<0.05).Logistic regression showed a high correlation between SBP-SD,SBP-CV,SBP-SV and the patient's 24-hour hematoma enlargement.【Conclusion】Variation in systolic blood pressure can predict and evaluate the expansion of hematoma in the acute phase of subarachnoid hemorrhage.