半球缺血性脑卒中急性期血压的预后价值

Q3 Social Sciences

Cardiovascular Therapy and Prevention Pub Date : 2024-02-14 DOI:10.15829/1728-8800-2024-3886

E. I. Gusev, O. Drapkina, M. Martynov, A. P. Glukhareva, E. V. Yutskova

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引用次数: 0

摘要

目的研究急性半球缺血性脑卒中（AIS）患者的血压变化，将AIS患者的血压与慢性脑缺血患者的血压相关联，并研究各种血压指标与脑卒中严重程度和恢复的关系。我们纳入了 235 名半球 AIS 患者（年龄为 64±11 岁；女性占 41.3%）。我们对患者的血压进行了以下 6 次评估：中风发病前一个月、救护车上、入院时、重症监护室 24 小时血压监测（BPM）、神经科（BPM）和中风后 90 天。对慢性脑缺血患者（178 人，年龄为 62±13 岁，女性占 46.1%）进行了 3 次血压评估：住院前一个月的患者自测、入院科室和神经科（BPM）。与慢性脑缺血患者相比，脑卒中前一个月内的AIS患者收缩压和脉压更高。与慢性脑缺血患者相比，在急性卒中期间，AIS 患者尽管收缩压和舒张压达到了目标值，但收缩压和舒张压的变异性明显增加。第1-2天和第9-10天连续记录的收缩压≥160毫米汞柱、脉压≥60毫米汞柱和收缩压变异性≥18毫米汞柱与第10天的美国国立卫生研究院卒中量表（NIHSS）评分（r≥0,37，p≤0,0017）和第90天的改良Rankin量表（mRS）评分（r≥0,29，p≤0,006）呈正相关。半球 AIS 患者在卒中前一个月的收缩压和脉压明显升高。在 AIS 发生的头 10 天内，收缩压、舒张压和脉压的持续升高以及血压的变化与中风的严重程度和较差的预后有关。在进行降压治疗时应考虑这些结果。

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Prognostic value of blood pressure in the acute period of hemispheric ischemic stroke

Aim. To study changes in blood pressure (BP) in patients with acute hemispheric ischemic stroke (AIS), to correlate BP in patients with AIS with BP in patients with chronic brain ischemia, and to study the association of various BP indices with stroke severity and recovery.Material and methods. We included 235 patients with hemispheric AIS (age 64±11 years; women, 41,3%). BP was assessed 6 times as follows: by patient’s self-measurement during the month before the stroke onset, in the ambulance, in the admission department, in the intensive care unit using 24-hour blood pressure monitoring (BPM), in the neurologic department (BPM), and 90 days after stroke. In patients with chronic cerebral ischemia (178 patients, age 62±13 years, 46,1% women), BP was assessed 3 times: by patient’s self-measurement during the month before hospitalization, in the admission department, and in the neurologic department (BPM).Results. Patients with AIS within the month before stroke had higher systolic and pulse pressure than patients with chronic cerebral ischemia. During the acute stroke period, patients with AIS despite reaching target systolic and diastolic BP had significantly increased variability of systolic and diastolic BP compared to patients with chronic brain ischemia. Systolic BP ≥160 mm Hg recorded consecutively in ambulance, in admission department, and in intensive care unit, as well as pulse pressure ≥60 mm Hg, and systolic BP variability ≥18 mm Hg recorded on day 1-2 and day 9-10, positively correlated with National Institute of Health Stroke Scale (NIHSS) score (r≥0,37, p≤0,0017) on day 10 and with modified Rankin Scale (mRS) score (r≥0,29, p≤0,006) on day 90.Conclusion. Patients with hemispheric AIS had significantly higher systolic BP and pulse pressure within the month before stroke. During the first 10 days of AIS persistent increase in systolic, diastolic, and pulse pressure, and BP variability was associated with more severe stroke and less favorable outcome. These results should be taken into account when administering antihypertensive treatment.

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来源期刊

Cardiovascular Therapy and Prevention Medicine-Cardiology and Cardiovascular Medicine

CiteScore

1.70

自引率

0.00%

发文量

155

审稿时长

6-12 weeks

期刊介绍： The most important objectives of the journal are: the generalization of scientific and practical achievements in the field of cardiology, increasing scientific and practical skills of cardiologists. The scientific concept of publication does the publication of modern achievements in the field of epidemiology, prevention and treatment of cardiovascular diseases, the results of research, national and international clinical trials. For publication in the journal are invited both domestic and foreign scientists and clinicians working in the field of cardiology, as well as doctors of other specialties. The magazine covers various issues in cardiology and related specialties. Each issue is prepared by Executive editor of the issue, a respected specialist in the field of epidemiology, prevention and treatment of cardiovascular diseases. The main focus of the publication — scientific articles on original research, the pharmacotherapy of cardiovascular disease, new diagnostic methods. All members of the group of authors should meet all four criteria of authorship set forth in the ICMJE recommendations: 1) concept and design development or data analysis and interpretation, and 2) manuscript justification or verification of critical intellectual content, and 3) final approval for publication of the manuscript, and 4) consent to be responsible for all aspects of the work, and assume that issues relating to the thoroughness and diligent execution of any part of the study submitted are duly investigated and resolved. Great importance the editors attached to the preparation of scientific papers by groups of authors at a high level, literacy, authors, and their ownership information, availability of research results not only to colleagues in Russia, but also abroad.