《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (09): 711-712.

• 专题 • 上一篇    下一篇

脑梗死急性期动态血压特点31例分析

鲍瑞雪; 张通   

  1. 北京博爱医院急诊科 北京市 100068
  • 收稿日期:2005-05-19 出版日期:2005-09-25 发布日期:2005-09-25

Characteristics of ambulatory blood pressure in 31 cerebral infarction cases at acute stage

BAO Rui-xue, ZHANG Tong   

  1. Department of Emergency, Beijing Charity Hospital, Beijing 100068, China
  • Received:2005-05-19 Published:2005-09-25 Online:2005-09-25

摘要: 目的分析发病24 h内脑梗死患者入院第1日动态血压水平及节律特点,探讨其与梗死类型、神经功能之间的关系。方法连续监测发病24 h内的31例脑梗死患者入院第一日血压情况。使用美国国立卫生研究院卒中评分(NIHSS)评价患者发病第1日、第5日神经功能缺损情况。结果83.87%入选患者夜间血压下降不足10%。24 h舒张压均数为NIHSS最重要的影响因素。NIHSS进步组夜间舒张压均数、夜平均动脉压均数较不变或恶化组低。结论急性脑梗死患者早期血压节律明显异常。第1日神经功能缺损与血压之间相互影响;夜舒张压、夜平均动脉压高的患者可能早期神经功能预后不良。

关键词: 动态血压, 脑梗死, 急性期, 神经功能缺损

Abstract: ObjectiveTo investigate the characteristics of the ambulatory blood pressure of acute cerebral infarction patients in the first 24 hours from onset and to study the relationship between their neurological deficit and characteristics of blood pressure.MethodsBlood pressure in 31 acute cerebral infarction patients (within 24 h) was measured serially during the first 24 hours in hospital with ambulatory blood pressure monitoring. Their neurological deficit was assessed with the National Institutes of Health stroke scale (NIHSS) on the first and the fifth day. Results83.87% nocturnal blood pressures decreased less than 10%. In multiple linear regression analysis, 24 h diastolic blood pressure (DBP) becomes the only and the most important factor to NIHSS on the first day. The patients with improved NIHSS on the fifth day showed lower nocturnal DBP and mean arterial pressure (MAP) than those of patients with unimproved NIHSS.ConclusionNot only the level but also the circadian of ambulatory blood pressure in acute cerebral infarction patients is significantly abnormal, especially for the reduction of nocturnal blood pressure decrease. On the first day, the neuroulogical deficit and blood pressure influence each other. The patients with higher nDBP and nMAP on the first day may be associated with poor early neurological function outcomes.

Key words: ambulatory blood pressure, cerebral infarction, acute stage, neurological deficit