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目的探讨脑梗死急性期血压变异性并分析血压变异性与急性脑梗死早期神经功能恶化的相关性。方法选择2013年1月—2014年12月收治的急性脑梗死住院患者120例作为研究对象,参照TOAST分型分为大动脉粥样硬化组70例,小动脉梗死组30例和非动脉粥样硬化组20例。入院3 d内行动态血压监测,计算收缩压、舒张压标准差,并分析各组早期神经功能恶化发生情况和早期神经功能恶化患者血压变异系数。计量资料采用方差分析,两两比较采用LSD-t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果大动脉粥样硬化组和小动脉梗死组日间收缩压标准差(daytime systolic standard deviation,d SSD)、日间舒张压标准差(daytime diastolic standard deviation,d DSD)、夜间收缩压标准差(night systolic standard deviation,n SSD),夜间舒张压标准差(night diastolic standard deviation,n DSD)分别为(14.76±1.81)、(13.28±1.72)、(9.12±1.68)、(8.28±1.72)、(12.83±1.75)、(12.28±1.64)、(8.63±1.56)、(7.96±1.48)mm Hg(1 mm Hg=0.133k Pa),均高于非动脉粥样硬化组的(11.32±1.52)、(7.12±1.62)、(10.37±1.42)、(7.22±1.37)mm Hg,差异均有统计学意义(均P<0.05)。结论血压变异性与脑梗死病因分型密切相关,与早期神经功能恶化密切相关。
Objective To investigate the relationship between blood pressure variability and early deterioration of neurological function after acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction hospitalized from January 2013 to December 2014 were enrolled in this study. According to TOAST classification, they were divided into 70 cases of atherosclerosis group, 30 cases of arteriole infarction group and non-atherosclerosis Group of 20 cases. Blood pressure monitoring was performed 3 days after admission to calculate the systolic blood pressure and diastolic blood pressure standard deviation, and to analyze the blood pressure variation coefficient of early neurological deterioration and early neurological deterioration in each group. Measurement data were analyzed by ANOVA, pairwise comparisons using LSD-t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The daytime systolic standard deviation (d SSD), daytime diastolic standard deviation (d DSD), nighttime systolic blood pressure standard deviation (nighttime systolic standard deviation, night systolic standard deviation (n SSD) and nighttime diastolic standard deviation (n DSD) were (14.76 ± 1.81), (13.28 ± 1.72), (9.12 ± 1.68), (8.28 ± 1.72), (12.83 (11.32 ± 1.52), (12.28 ± 1.64), (8.63 ± 1.56) and (7.96 ± 1.48) mm Hg (1 mm Hg = 0.133kPa) in the non-atherosclerosis group, 7.12 ± 1.62, 10.37 ± 1.42 and 7.22 ± 1.37 mm Hg, respectively (all P <0.05). Conclusion The variability of blood pressure is closely related to the etiological classification of cerebral infarction, which is closely related to the deterioration of early neurological function.