静脉溶栓24 h内血压变异系数对急性脑梗死出血性转化的预测价值

Predictive value of blood pressure variability coefficient within 24 hours of intravenous thrombolysis for hemorrhagic transformation in acute cerebral infarction

目的 :探讨静脉溶栓24 h内血压变异系数对急性脑梗死出血性转化的预测价值。方法 :263例行静脉溶栓治疗的急性脑梗死患者分为出血转化组75例与非出血转化组188例。比较两组溶栓24 h内血压变异系数差异,行逐步logistic回归分析,利用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析24 h血压变异度(BPV)在预测出血转化中的价值。结果 :出血转化组患者溶栓24 h BPV水平高于非出血转化组(P <0.05)。逐步logistic回归分析显示,24 h BPV升高的患者发生出血转化的危险性增加(P <0.05)。ROC曲线分析显示,静脉溶栓后24 h内BPV在预测出血转化的ROC曲线下面积(AUC)分别是0.710、0.734、0.806、0.819、0.849,联合预测因子AUC为0.956。结论 :静脉溶栓治疗后24 h BPV指标对患者出血转化发生有一定的预测价值。

Objective:To explore the predictive value of blood pressure variability coefficient within 24 hours of intravenous thrombolysis for hemorrhagic transformation in acute cerebral infarction.Methods:A total of 263 patients with acute cerebral infarction undergoing intravenous thrombolytic therapy were divided into a bleeding conversion group with 75 patients and a non-bleeding conversion group with 188 patients.The differences between the two groups in 24-hour blood pressure variability(BPV)were compared and a stepwise logistic regression analysis was performed and the receiver operating characteristic(ROC)curve was used to analyze the value of 24-hour BPV in predicting bleeding conversion.Results:The 24 h BPV indicators were higher in the bleeding conversion group than the non-bleeding conversion group(all P<0.05).Stepwise logistic regression analysis showed that patients with elevated 24 h BPV indicators had an increased risk of bleeding conversion(P<0.05).ROC curve analysis showed that the area under the ROC curve(AUC)of BPV indicators in predicting hemorrhagic transformation within 24 h after intravenous thrombolysis were 0.710,0.734,0.806,0.819,and 0.849,respectively,and the combined predictor AUC was 0.956.Conclusion:The combined indicators of 24-hour BPV have certain predictive value for the occurrence of bleeding transformation in patients.