原发性高血压短时血压变异性与缺血性脑卒中及其预后的相关性研究

杨虹; 方君; 张晓瑜; 庄佳运

doi:10.13201/j.issn.1009-5918.2021.10.010

原发性高血压短时血压变异性与缺血性脑卒中及其预后的相关性研究

- 1. 昆山市中医医院心电科(江苏昆山, 215300);
- 2. 昆山市中医医院心血管内科;
- 3. 昆山市中医医院神经内科

详细信息

通讯作者: 方君,E-mail:55559906@163.com

中图分类号: R743.3

收稿日期: 2021-06-06

Correlation between short-term blood pressure variability of primary hypertension and ischemic stroke and its prognosis

- 1 Department of Electrocardiography, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, 215300, China;
- 2 Department of Cardiology, Kunshan Hospital of Traditional Chinese Medicine;
- 3 Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine

More Information

Corresponding author: FANG Jun, E-mail: 55559906@163.com

Received Date: 06 June 2021

摘要

摘要: 目的:探讨原发性高血压患者短时血压变异性(blood pressure variability, BPV)与缺血性脑卒中及其预后的相关性。方法:本研究为回顾性研究,以昆山市中医医院神经内科2018年9月-2019年12月期间收治的51例原发性高血压合并缺血性脑卒中患者为缺血性脑卒中组(A组);同时以我院心血管内科收治的34例原发性高血压患者为原发性高血压组(B组),比较两组BPV量化指标[收缩压标准差(dSSD)、白天的舒张压标准差(dDSD)、夜间的收缩压标准差(nSSD)、夜间的舒张压标准差(nDSD)、24 h的收缩压标准差(24hSSD)、24 h的舒张压标准差(24hDSD)]并分析其与缺血性脑卒中的关系。并根据A组3个月随访结果进一步将其分为预后不良组(A1组)和预后良好组(A2组),衡量短时BPV对缺血性脑卒中预后的预测价值。结果:A组dSSD、nSSD、nDSD、24hSSD均高于B组,差异有统计学意义(P<0.05),而在一般资料、实验室检查及dDSD、24hDSD方面两组差异无统计学意义(P>0.05);二元Logistic回归分析显示,dSSD、nSSD与缺血性脑卒中的发病显著相关,OR(95%CI)分别为1.848(1.151~2.965)和1.227(1.015~1.484)(均P<0.05)。A1组年龄、dSSD、dDSD、24hSSD均高于A2组,差异有统计学意义(P<0.05);ROC曲线显示dSSD、dDSD、24hSSD对缺血性脑卒中3个月预后的预测更有价值,曲线下方面积(95%CI)分别为0.729(0.585~0.874)、0.677(0.525~0.829)和0.735(0.587~0.882)(均P<0.05)。而年龄则没有明显的预测价值(P>0.05)。结论:短时BPV的增大与缺血性脑卒中的发病显著相关,并对其3个月预后有一定的预测价值,在临床工作中应重视缺血性脑卒中患者的短时BPV。
- 血压变异性 /
- 缺血性脑卒中 /
- 预后
Abstract: Objective:To investigate the correlation of short-term blood pressure variability(BPV) and ischemic stroke in patients with essential hypertension and its prognosis.Methods:A retrospective analysis was conducted. Clinical data of 51 patients with essential hypertension complicated with ischemic stroke(ischemic stroke group, group A) admitted to the Department of Neurology and 34 patients with essential hypertension(essential hypertension group, group B) admitted to the Department of Cardiovascular Medicine in Kunshan Hospital of Traditional Chinese Medicine from September 2018 to December 2019 were analyzed retrospectively. The relationship between quantitative indicators of BPV and ischemic stroke was compared between the two groups. According to the 3-month follow-up, the ischemic stroke group(group A) was further divided into two groups:poor prognosis group(A1 group) and good prognosis group(A2 group), and the predictive value of short-term BPV on the prognosis of ischemic stroke was measured.Results:dSSD, nSSD, nDSD and 24 hSSD in group A were higher than those in group B(P<0.05), but there were no significant differences between the two groups in general data, laboratory examination, dDSD and 24 hDSD(P>0.05). Binary logistic regression analysis showed that dSSD and nSSD were significantly correlated with the incidence of ischemic stroke, with OR(95%CI) of 1.848(1.151-2.965) and 1.227(1.015-1.484), respectively(all P<0.05). The age, dSSD, dDSD and 24 hSSD in A1 group were higher than those in A2 group, and the difference was statistically significant(P<0.05); ROC curve showed that dSSD, dDSD and 24 hSSD were more valuable in predicting the 3-month prognosis of ischemic stroke. The areas under the curve(95%CI) were 0.729(0.585-0.874), 0.677(0.525-0.829) and 0.735(0.587-0.882), respectively(all P<0.05). But age had no significant predictive value(P>0.05).Conclusion:The increase of short-term BPV is significantly related to the incidence of ischemic stroke, and it has a certain predictive value for its 3-month prognosis. We should pay attention to the short-term BPV of patients with ischemic stroke in clinical work.
- blood pressure variability /
- ischemic stroke /
- prognosis

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