Bentsen L, Ovesen C, Christensen A F, Christensen H
Department of Neurology, Copenhagen University Hospital, Bispebjerg Bakke 23, Bispebjerg, 2400 Copenhagen NV, Denmark.
Int J Hypertens. 2013;2013:610353. doi: 10.1155/2013/610353. Epub 2013 Jul 31.
Background. The association between outcome and elevated admission blood pressure (BP) remains uncertain in acute stroke patients. The aim of the present study was to examine the association between admission blood pressure and outcome in ischemic stroke patients treated with tissue plasminogen activator (tPA). Method. This study included patients treated with tPA within 4.5 hours after symptom onset. Four quartiles based on the admission BP values were defined. BP development of the first 12 hours was compared to outcome parameters defined as NIHSS 24 hours after tPA and mRS after 3 months. Results. 265 patients were included. A trend with worse short- and long-term outcome was present in the quartiles with the lowest and highest admission BP compared to the quartile with admission values at 140-160 mm Hg systolic. BP in quartile 1 was insignificantly decreased after 12 hours while the BP in quartiles 3 and 4 remained above recommended levels. Conclusion. Admission BP is associated with short- and long-term outcome after stroke. Low- or high-admission BP indicates cardiac comorbidity or preexisting hypertension, where close monitoring and further examinations are requested to prevent poorer outcome.
背景。急性卒中患者的预后与入院时血压升高之间的关联仍不明确。本研究的目的是探讨接受组织型纤溶酶原激活剂（tPA）治疗的缺血性卒中患者入院血压与预后之间的关联。方法。本研究纳入症状发作后4.5小时内接受tPA治疗的患者。根据入院血压值定义四个四分位数。将最初12小时的血压变化与tPA治疗后24小时的美国国立卫生研究院卒中量表（NIHSS）评分及3个月后的改良Rankin量表（mRS）评分所定义的预后参数进行比较。结果。共纳入265例患者。与收缩压为140 - 160 mmHg的入院血压四分位数相比，入院血压最低和最高的四分位数患者短期和长期预后呈较差趋势。第1四分位数的血压在12小时后无显著下降，而第3和第4四分位数的血压仍高于推荐水平。结论。入院血压与卒中后的短期和长期预后相关。入院血压低或高提示存在心脏合并症或既往高血压，需密切监测并进一步检查以预防较差的预后。
