Han Xinsheng, Zhang Gaocai, Liu Ning, Zhang Hongyang, Xu Jianke, Han Miao, Zhang Yun, Zhang Yan, Chen Li
The Fifth Ward of Neurology Department, Kaifeng Central Hospital, Kaifeng 475000, Henan Province, China.
The Child Neurology Department, Kaifeng Children's Hospital, Kaifeng 475000, Henan Province, China.
Int J Hypertens. 2020 Jul 11;2020:1203546. doi: 10.1155/2020/1203546. eCollection 2020.
Increased blood pressure (BP) variability may worsen the prognosis of stroke. This study aimed at investigating the association between BP variability and early functional prognosis in patients with pontine infarction.
According to types of pontine infarction, all the 137 patients were divided into two groups: 70 patients with paramedian pontine infarction (PPI) and 67 patients with deep pontine infarction (DPI). Common risk factors, 24-hour continuous blood pressure monitoring data, and the coefficient of variation were collected after admission in the hospital. Functional outcomes were evaluated with modified Rankin scale (mRS) at 3 months after discharge (favorable outcome: mRS scores ≤ 2; poor outcome: mRS scores > 2).
The level of Glu, HbA1c, LDL, and NIHSS scores in the PPI group was significantly higher than that in the DPI group, and the concentration of blood uric acid was lower in the PPI group. Diastolic pressure in the PPI group is significantly higher than that in the DPI group, and coefficient of variation (CV) of systolic pressure in PPI is higher when compared with DPI ((88.77 ± 1.71) mmHg vs. (80.74 ± 1.31) mmHg; (11.54 ± 0.35) vs. (10.24 ± 0.25)). In multivariate analyses, the CV of systolic pressure, diastolic pressure, NIHSS scores, and the paramedian pontine infarction was independently associated with 3-month clinical outcome (OR = 1.94, 95% CI = 1.252-2.994, =0.003; OR = 1.08, 95% CI = 1.002-1.166, =0.04; OR = 1.58, 95% CI = 1.164-2.159, =0.003; OR = 9.87, 95% CI = 1.045-32.193, =0.04).
In conclusion, increased 24-hour (BP) variability, NIHSS scores, and paramedian pontine were associated with early poor prognosis in patients with acute pontine infarction.
血压（BP）变异性增加可能会使中风的预后恶化。本研究旨在调查脑桥梗死患者的血压变异性与早期功能预后之间的关联。
根据脑桥梗死类型，将137例患者分为两组：70例脑桥旁正中梗死（PPI）患者和67例脑桥深部梗死（DPI）患者。入院后收集常见危险因素、24小时连续血压监测数据以及变异系数。出院3个月时用改良Rankin量表（mRS）评估功能结局（良好结局：mRS评分≤2；不良结局：mRS评分>2）。
PPI组的Glu、糖化血红蛋白（HbA1c）、低密度脂蛋白（LDL）水平和美国国立卫生研究院卒中量表（NIHSS）评分显著高于DPI组，PPI组的血尿酸浓度较低。PPI组的舒张压显著高于DPI组，PPI组收缩压的变异系数（CV）高于DPI组（（88.77±1.71）mmHg对（80.74±1.31）mmHg；（11.54±0.35）对（10.24±0.25））。在多因素分析中，收缩压CV、舒张压、NIHSS评分和脑桥旁正中梗死与3个月临床结局独立相关（比值比（OR）=1.94，95%置信区间（CI）=1.252 - 2.994，P = 0.003；OR = 1.08，95% CI = 1.002 - 1.166，P = 0.04；OR = 1.58，95% CI = 1.164 - 2.159，P = 0.003；OR = 9.87，95% CI = 1.045 - 32.193，P = 0.04）。
总之，24小时血压变异性增加、NIHSS评分和脑桥旁正中梗死与急性脑桥梗死患者早期预后不良相关。
