急性脑卒中患者发病24h内血压变化与其早期病死率的关系

    Relationship between mortality and blood pressure admission in patients with acute stroke

    • 摘要: 目的: 探讨急性脑卒中患者发病24 h内血压(收缩压和舒张压)的变化与早期病死率(1个月)及病死原因之间的关系。方法: 研究3年来第一次确诊急性脑卒中患者46,监测发病24 h内血压(收缩压和舒张压),随访1个月。结果: 急性缺血或出血性脑卒中患者的病死率与入院时收缩压和舒张压成"U"关系。急性脑卒中患者急性期有一个最佳血压:缺血性为121~140/81~90 mmHg,出血性为141~160/91~100 mmHg,大于或小于该血压病死率均增高(P<0.05~P<0.01)。发病24 h内收缩压低于等于"U"形线低点的患者最常见的病死原因是心血管疾病,高于"U"形线低点的则是严重脑损伤。结论: 急性缺血或出血性脑卒中患者发病24 h内血压过低或过高均与早期病死率增加有关,血压低者高病死率与心脏疾病有关;血压高者高病死率与脑水肿致严重脑损伤有关。

       

      Abstract: Objective: To evaluate the relationship between systolic blood pressure(SBP) or diastolic blood pressure(DBP) on admission and early mortality in patients with acute stroke.Methods: A total of 461 patients admitted within 24 h from stroke onset and followed up for 1 month.Mortality at 1 month after stroke in relation to admission SBP and DBP.Results: Early mortality in patients with acute ischaemic or haemorrhagic stroke in relation to admission SBP and DBP followed a U-curve pattern.The nadir or U-point of the curve occurred in the range of 121-140/81-90 mmHg and 141-160/91-100 mmHg for ischaemic or haemorrhagic stroke patients.The patients with high and low admission BP-values have a higher early mortality(P<0.05~P<0.01).Death due to cerebral oedema was significantly more frequent in patients with high admission SBP-values,whereas death due to cardiovascular disease was more frequent in patients with low admission SBP-values.Conclusions: Acute ischaemic or haemorrhagic stroke patients with high and low admission BP-values have a higher early mortality.Coincidence of heart disease is associated with low initial BP-values.Death due to neurological damage from brain oedema is associated with high initial BP-values.

       

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