Abboud Halim, Labreuche Julien, Plouin François, Amarenco Pierre
Department of Neurology and Stroke Centre, Bichat University Hospital and Medical School, Paris, France.
J Hypertens. 2006 Feb;24(2):381-6. doi: 10.1097/01.hjh.0000200516.33194.e3.
To evaluate the prognostic value of admission blood pressure in patients with acute ischemic stroke by determining whether it contributes to clinical outcome and vascular death.
We studied 230 consecutive patients admitted within the first 24 h after the onset of ischemic stroke. We used the first systolic and diastolic blood pressure measurements recorded on admission. The functional outcome was assessed on the basis of mortality or dependency (Rankin Scale > 3) at the 10-day and 6-month visits.
High systolic blood pressure on admission was associated with poor outcome at the 10-day and 6-month visits, independent of the baseline risk factors but not of the severity of the initial stroke (odds ratio, 1.39; 95% confidence interval, 0.50-3.87). The spontaneous decrease in systolic blood pressure within the first 10 days was higher in patients with functional improvement. The admission blood pressure was not significantly associated with total and vascular deaths, except for a threshold effect of diastolic blood pressure.
After an acute stroke, the relationship between blood pressure and clinical outcome depended on the severity of the stroke on presentation, and on the level and trend of the systolic blood pressure during the first 24 h.
通过确定入院血压是否影响临床结局和血管性死亡，评估其对急性缺血性脑卒中患者的预后价值。
我们研究了230例在缺血性脑卒中发病后24小时内入院的连续患者。我们采用入院时记录的首次收缩压和舒张压测量值。根据10天和6个月随访时的死亡率或依赖程度（Rankin量表>3）评估功能结局。
入院时高收缩压与10天和6个月随访时的不良结局相关，与基线危险因素无关，但与初始脑卒中的严重程度无关（优势比，1.39；95%置信区间，0.50-3.87）。功能改善患者在最初10天内收缩压的自发下降更高。入院血压与全因死亡和血管性死亡无显著相关性，但舒张压存在阈值效应。
急性脑卒中后，血压与临床结局的关系取决于就诊时脑卒中的严重程度，以及最初24小时内收缩压的水平和变化趋势。
