摘要
目的探讨颅内动脉狭窄、血压变异性与急性缺血性脑卒中(AIS)患者神经功能及预后的关系。方法回顾性分析2018年1月—2021年1月收治的AIS 152例的临床资料。根据是否发生早期神经功能恶化(END)分为END组(n=45)和非END组(n=107)。根据卒中发病后90 d的预后情况分为预后良好组(n=60)和预后不良组(n=92)。评估颅内动脉狭窄程度,监测24 h动态血压,计算收缩压标准差(SSD)、舒张压标准差(DSD)。分析影响患者预后的危险因素。结果END组颅内动脉总狭窄率高于非END组,且END组颅内动脉狭窄程度更严重(P<0.05,P<0.01)。END组24 h SSD、24 h DSD、日间SSD、日间DSD、夜间SSD、夜间DSD均高于非END组(P<0.05,P<0.01)。END组杓型血压节律的比例低于非END组,而非杓型血压节律的比例高于非END组(P<0.05,P<0.01)。颅内动脉中、重度狭窄及入院时美国国立卫生研究院卒中量表评分>12分、24 h SSD>12 mmHg、发生END是导致AIS患者预后不良的危险因素,而杓型血压节律为保护性因素(P<0.05,P<0.01)。结论颅内动脉狭窄程度、血压变异性与AIS患者神经功能有关,且是预后的影响因素。
Objective To investigate the relationship of intracranial artery stenosis and blood pressure variability with nerve function and prognosis of patients with acute ischemic stroke(AIS).Methods A retrospective analysis was performed on the clinical data of 152 patients with AIS admitted to the hospital between January 2018 and January 2021.According to presence or absence of early neurological deterioration(END),they were divided into END group(n=45)and non-END group(n=107).According to prognosis within 90 d after stroke onset,they were divided into good prognosis group(n=60)and poor prognosis group(n=92).The severity of intracranial artery stenosis was evaluated,24-h ambulatory blood pressure was monitored,and systolic standard deviation(SSD)and diastolic standard deviation(DSD)were calculated.The risk factors of poor prognosis were analyzed.Results The total incidence of intracranial artery stenosis in END group was higher than that in non-END group,and stenosis severity was more serious than that in non-END group(P<0.05,P<0.01).24-h SSD,24-h DSD,daytime SSD,daytime DSD,nighttime SSD and nighttime DSD in END group were higher than those in non-END group(P<0.05,P<0.01).The proportion of dipper blood pressure rhythm in END group was lower than that in non-END group,and proportion of non-dipper blood pressure rhythm was higher than that in non-END group(P<0.05,P<0.01).Moderate and severe intracranial artery stenosis,National Institutes of Health Stroke Scale(NIHSS)score at admission>12 points,24-h SSD>12 mmHg,and END were risk factors for poor prognosis in AIS patients,and dipper blood pressure rhythm was a protective factor(P<0.05,P<0.01).Conclusion Intracranial arterial stenosis and blood pressure variability are related to nerve function in AIS patients,which are influencing factors of poor prognosis.
作者
霍康
宋文锋
刘福德
陈晨
于嘉
罗国刚
韩建峰
HUO Kang;SONG Wenfeng;LIU Fude;CHEN Chen;YU Jia;LUO Guogang;HAN Jianfeng(Department of Neurology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710000,China)
出处
《临床误诊误治》
CAS
2023年第5期83-87,共5页
Clinical Misdiagnosis & Mistherapy
基金
陕西省重点研发计划项目(S2021-VFSF-0491)。
