不同类型急性脑卒中血压变化的动态观察

Trend Observation of Blood Pressure Change on Different Types of Acute Cerebral Apoplexy

目的探讨不同类型急性脑卒中患者血压的变化规律。方法 96例急性脑卒中患者,其中42例发生脑出血;54例发生脑梗塞:以同期65例Ⅰ期高血压对照,全部患者均作1—3天的24小时动态血压测定:并于第二天始每隔12小时记录1次,连续记录7天,至第14天再记录1次:结果 脑出血组与脑梗塞组24小时及夜间平均收缩压和舒张压均较对照组升高,有显著差异(P<0.05)。但脑出血组较脑梗塞组更明显,二组有显著差异(P<0.05)。上午平均舒张压和下午平均收缩压脑出血组高于脑梗塞组,差异显著(P<0.05)。血压下降率在脑出血组与脑梗塞组亦有明显差异(P<0.05):而高血压患者发生脑梗塞组、脑出血的危险性分别是非高血压患者的3—4倍:急性脑卒中后84%患者血压迅速升高,于12小时达到高峰,4天内逐渐下降至低水平。结论血压的昼夜波动变化特点与发生脑卒中的类型有密切关系。急性脑卒中后血压的变化呈先升后降的自然规律。高血压患者急性脑卒中的发生率明显高于非高血压患者。

Objective To explore the blood pressure change regular on different types of acute cerebral apoplexy patients.Methods 42 cases were cerebral hemorrhage and 54 cases were cerebral infarction among 96 cases hypertension patients.65 cases of I -period hypertension were contrasted,all were determined 24-hours trends blood pressure from 1 to 3 days,and recorded the blood pressure values one time every 12 hours from the second day to 7 days after, then recorded it again on the fourteenth day .Results Cerebral hemorrhage group and cerebral infarction group were higher than the control group in average systole pressure and diastole pressure of 24 hours and nighttime,they had remarkable differences (P<0.05);but cerebral hemorrhage group and cerebral infarction group had remarkable differences (P<0.05); two groups had remarkable differences on the blood pressure drop rate (P<0.05); The chance of hypertension patients falling cerebral hemorrhage or cerebral infarction was 3 and 4 times as non-hypertension patients respectively The blood pressure of 84 percent patients after falling acute cerebral apoplexy rose quickly,and reached the peak in 12 hours,then dropped gradually to low level.Conclusions The change feature of blood pressure fluctuating was closely relative to the type of falling cerebral apoplexy.The change of blood pressure after acute cerebral apoplexy assumed the natural regular of early rising and late dropping.The incidence of acute cerebral apoplexy was higher obviously in hypertension patients than in non-hypertension patients.