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血压对动脉粥样硬化血栓形成性梗死住院患者康复结局的影响:一项回顾性横断面研究。

Effect of blood pressure on recovery outcomes in inpatients with atherothrombotic infarction: A retrospective cross-sectional study.

作者信息

Saito Naohito, Nishikawa Tetsuo, Ota Tetsuo

机构信息

Department of Physical Medicine and Rehabilitation, Sunagawa City Medical Center, Sunagawa, Hokkaido, Japan.

Endocrinology & Diabetes Center, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan.

出版信息

Medicine (Baltimore). 2025 Mar 14;104(11):e41796. doi: 10.1097/MD.0000000000041796.

Abstract

Stroke is one of the leading causes of death worldwide, and the relationship between blood pressure (BP) and outcomes after atherothrombotic infarction has been studied from various perspectives. However, the relationship of BP with rehabilitation outcomes and activities of daily living after atherothrombotic infarction has not been studied extensively. This study aims to investigate the effect of BP on rehabilitation outcomes and activities of daily living after atherothrombotic infarction. In this retrospective cross-sectional study, we analyzed data obtained from the Japan Association of Rehabilitation Database for inpatients undergoing rehabilitation using Wilcoxon's test, Pearson's chi-squared test, or Fisher's exact test. The patients were initially categorized into hypertensive and non-hypertensive groups and were assessed using the 10-item Barthel index (BI) activities and total BI at hospital discharge. The patients were further dichotomized into dependent (patients with scores of 0 for each activity) and nondependent groups based on the BI activities. Compared with hypertensive conditions (n = 108), non-hypertensive conditions (n = 213) were associated with higher dependence (feeding, transfers, toilet use, dressing, and bowel and bladder control). The proportion of non-hypertensive patients with a severely low BI (0-15) was higher than that of hypertensive patients. The hypertensive group had a greater increase in the BI (25 vs 15, P = .006) and daily BI (1.2 vs 0.74, P = .014) than the non-hypertensive group. During in-hospital rehabilitation, hypertensive patients recovered more efficiently than their non-hypertensive counterparts, emphasizing the need for personalized rehabilitation plans based on their individual BP profiles. Our results underscore the impact of BP on inpatients after atherothrombotic infarction, indicating that more non-hypertensive inpatients are affected by BP while receiving treatment than are hypertensive inpatients during rehabilitation.

摘要

中风是全球主要死因之一,人们已从多个角度研究了血压(BP)与动脉粥样硬化血栓形成性梗死预后之间的关系。然而,血压与动脉粥样硬化血栓形成性梗死后康复结局及日常生活活动之间的关系尚未得到广泛研究。本研究旨在探讨血压对动脉粥样硬化血栓形成性梗死后康复结局及日常生活活动的影响。在这项回顾性横断面研究中,我们使用Wilcoxon检验、Pearson卡方检验或Fisher精确检验,分析了从日本康复数据库获得的接受康复治疗的住院患者数据。患者最初被分为高血压组和非高血压组,并在出院时使用10项巴氏指数(BI)活动和总BI进行评估。根据BI活动,患者进一步分为依赖组(每项活动得分为0的患者)和非依赖组。与高血压情况(n = 108)相比,非高血压情况(n = 213)与更高的依赖程度(进食、转移、如厕、穿衣以及肠道和膀胱控制)相关。BI严重偏低(0 - 15)的非高血压患者比例高于高血压患者。高血压组的BI增加幅度(25对15,P = 0.006)和每日BI增加幅度(1.2对0.74,P = 0.014)均高于非高血压组。在住院康复期间,高血压患者比非高血压患者恢复得更有效,这强调了需要根据个体血压情况制定个性化康复计划。我们的结果强调了血压对动脉粥样硬化血栓形成性梗死后住院患者的影响,表明在接受治疗期间,受血压影响更多的非高血压住院患者比康复期间的高血压住院患者更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5193/11922399/e7091685b1e6/medi-104-e41796-g001.jpg

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