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缺血性脑卒中后即刻血压与脑灌注和神经功能相关。

Blood pressures immediately following ischemic strokes are associated with cerebral perfusion and neurologic function.

机构信息

The First People's Hospital of Lianyungang City, Lianyungang, Jiangsu, China.

State Key Laboratory of Cardiovascular Disease, Sino-German Laboratory for Molecular Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Clin Hypertens (Greenwich). 2018 Jun;20(6):1008-1015. doi: 10.1111/jch.13310. Epub 2018 May 23.

Abstract

The optimal range of blood pressure levels in the early phase of ischemic stroke with hypertension is still controversial. Based on our stroke registry database, we explored the relationship between blood pressure levels and cerebral perfusion in the early phase of ischemic stroke with hypertension and neurofunctional recovery at 3 months after stroke. Total 732 stroke patients with hypertension were finally analyzed. Patients were divided into quintiles according to systolic blood pressure (SBP) and diastolic blood pressure (DBP) to perform multivariable logistic regression to analyze their relation with neurofunctional recovery, respectively. The cerebral perfusion levels displayed a reverse "U" shape curve with the change of blood pressure levels. Sufficient estimated cerebral blood flow (ECBF) in the early phase of ischemic stroke was associated with good neurofunctional recovery at 3 months after stroke. The best neurofunctional recovery was observed in the middle quintiles with SBP at 161 to 177 mm Hg and DBP at 103 to 114 mm Hg, respectively. So maintaining appropriate blood pressure levels in the early phase of ischemic stroke might be beneficial to cerebral perfusion and neurofunctional recovery.

摘要

高血压性缺血性卒中早期的最佳血压水平范围仍存在争议。基于我们的卒中登记数据库,我们探讨了高血压性缺血性卒中早期血压水平与脑灌注及卒中后 3 个月神经功能恢复的关系。共分析了 732 例高血压性卒中患者。根据收缩压(SBP)和舒张压(DBP)将患者分为五组,分别进行多变量逻辑回归分析其与神经功能恢复的关系。脑灌注水平与血压水平的变化呈反向“U”形曲线。缺血性卒中早期有足够的估计脑血流量(ECBF)与卒中后 3 个月的良好神经功能恢复相关。SBP 为 161 至 177mmHg 和 DBP 为 103 至 114mmHg 的中间五分位组观察到最佳的神经功能恢复。因此,维持缺血性卒中早期适当的血压水平可能有利于脑灌注和神经功能恢复。

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