Geng Shan, Liu Na, Meng Pin, Ji Niu, Sun Yong'an, Xu Yingda, Zhang Guanghui, He Xiaobing, Cai Zenglin, Wang Bei, Xu Bei, Li Zaipo, Niu Xiaoqin, Zhang Yongjin, Xu Bingchao, Zhou Xinyu, He Mingli
Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China.
Front Neurol. 2017 Jul 28;8:365. doi: 10.3389/fneur.2017.00365. eCollection 2017.
The aim of this study was to investigate the relationship between blood pressure variability (BPV) and poststroke cognitive impairment (PSCI).
Seven-hundred ninety-six patients with acute ischemic stroke were included in this study. Midterm BPV was evaluated by calculating the SD and coefficient of variation (CV, 100 × SD/mean) of systolic blood pressure (SBP) and diastolic blood pressure during the 7 days after stroke onset. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at admission and at all follow-up visits. Patients with MoCA scores <26 were considered to have PSCI.
The incidence of PSCI reached its peak (72%) 3 months after stroke onset and decreased to 30.3% at 12 months poststroke. After adjusting for covariables, the increase in the prevalence of PSCI at 3 months was independently associated with increases in the CV of blood pressure during the 7 days after stroke [odds ratios and 95% CI for patients in the second to fifth quintiles of SBP CV were 2.28 (1.18, 4.39), 2.33 (1.18, 4.62), 2.69 (1.31, 5.53), and 4.76 (1.95, 11.67), respectively]. Sub-analysis of the MoCA scores revealed that the patients had impairments in visuoperceptual abilities and executive functions, as well as in naming and delayed recall ( < 0.05).
Midterm BPV during the early phase of acute ischemic stroke is independently associated with PSCI, especially in the visuoperceptual, executive, and delayed recall domains.
http://www.chictr.org.cn, identifier ChiCTR-TRC-14004804.
本研究旨在探讨血压变异性（BPV）与卒中后认知障碍（PSCI）之间的关系。
本研究纳入了796例急性缺血性卒中患者。通过计算卒中发作后7天内收缩压（SBP）和舒张压的标准差（SD）及变异系数（CV，100×SD/均值）来评估中期BPV。在入院时及所有随访时使用蒙特利尔认知评估量表（MoCA）评估认知功能。MoCA评分<26分的患者被认为患有PSCI。
PSCI的发生率在卒中发作后3个月达到峰值（72%），在卒中后12个月降至30.3%。在对协变量进行校正后，3个月时PSCI患病率的增加与卒中后7天内血压CV的增加独立相关[SBP CV第二至第五分位数患者的优势比及95%可信区间分别为2.28（1.18，4.39）、2.33（1.18，4.62）、2.69（1.31，5.53）和4.76（1.95，11.67）]。对MoCA评分的亚分析显示，患者在视觉感知能力、执行功能以及命名和延迟回忆方面存在损害（<0.05）。
急性缺血性卒中早期的中期BPV与PSCI独立相关，尤其是在视觉感知、执行和延迟回忆领域。
