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目的探讨分水岭脑梗死的血压调控与预后的相关性。方法选取2013年6月—2016年6月在本院住院的分水岭脑梗死患者136例,随机分为对照组和观察组各68例,对照组采用常规治疗,观察组在对照组的基础上给予多巴胺静脉点滴进行升压治疗,使收缩压较入院时上升20 mm Hg(1 mm Hg=0.133 k Pa)左右,维持3 d,监测两组患者的血压和评估预后。计量资料不同治疗时间比较采用重复测量资料的方差分析,LSD法进行两两比较;计数资料比较采用χ2检验,等级资料比较采用秩和检验,P<0.05为差异有统计学意义。结果不同治疗时间舒张压、收缩压比较,差异均有统计学意义(均P<0.05);两组患者舒张压、收缩压比较,差异均有统计学意义(均P<0.05)。观察组升压治疗第1、2、3天的血压均较对照组升高,差异均有统计学意义(均P<0.05)。两组患者疗效(1.47%、17.65%、44.12%、22.06%、14.71%与5.88%、51.47%、27.94%、11.76%、2.94%)比较,差异有统计学意义(P<0.05);两组患者神经功能(51.47%、48.53%与82.35%、17.65%)、日常生活能力(41.18%、58.82%与10.29%、89.71%)比较,差异均有统计学意义(均P<0.05)。结论短期升压治疗可改善分水岭脑梗死患者的预后。
Objective To investigate the relationship between the regulation of blood pressure and prognosis in watershed cerebral infarction. Methods Thirty-six patients with watershed cerebral infarction hospitalized in our hospital from June 2013 to June 2016 were randomly divided into control group and observation group, 68 cases in each group. The control group was treated with conventional therapy. The observation group was given on the basis of the control group Dopamine intravenous drip for vasopressor treatment increased the systolic blood pressure by 20 mm Hg (1 mm Hg = 0.133 k Pa) at admission and maintained for 3 days. Blood pressure and prognosis were monitored in both groups. The measurement data were compared with different treatment time by repeated measures of variance analysis, LSD method for any comparison; count data were compared using the χ2 test, rank data comparison using rank sum test, P <0.05 for the difference was statistically significant. Results There were significant differences in diastolic blood pressure and systolic blood pressure between different treatment groups (all P <0.05). There was significant difference in diastolic blood pressure and systolic blood pressure between the two groups (all P <0.05). The blood pressure in the observation group was significantly higher than that in the control group on the 1st, 2nd and 3rd days (P <0.05). There was significant difference between the two groups (P <0.05). The difference was statistically significant (P <0.05) between the two groups (1.47%, 17.65%, 44.12%, 22.06%, 14.71% and 5.88%, 51.47%, 27.94%, 11.76%, 2.94% There were significant differences in neurological function (51.47%, 48.53% vs 82.35%, 17.65%) and daily living ability (41.18%, 58.82% vs 10.29%, 89.71%, respectively) (all P <0.05). Conclusion Short-term boost therapy can improve the prognosis of patients with watershed cerebral infarction.