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目的探讨脑血栓形成急性期降血压治疗对患者神经功能和生活质量的影响。方法收集发病48 h内的328例首次脑血栓形成病例,随机分为降压组161例和对照组167例。降压组24 h内予以降血压治疗,降血压幅度为10%~25%,但不低于126/80 mm Hg;7 d内保持血压<140/90 mm Hg,并于14 d内维持此水平;对照组不予以降血压治疗。发病后90 d对两组患者进行随访,应用改良Rankin量表和SF-36健康调查量表评价两组患者的神经功能和生活质量,并进行多因素Logistic回归分析降血压治疗与神经功能的关系。结果降压组的血压在随机分组后的1~14 d和90d时间点明显低于对照组(P<0.000 1);第14和90天时,改良Rankin量表评分[分别为2.0(1.0~3.0)和1.0(1.0~3.0)]和SF-36量表各维度评分与对照组[分别为2.0(1.0~3.0)和1.0(1.0~3.0)]比较,均差异无统计学意义(P>0.05);Logistic回归:提示脑血栓形成急性期降血压治疗不影响患者第14和90天的神经功能[OR=0.98,P=0.70;OR=0.96,P=0.52]。结论脑血栓形成急性期降血压治疗不增加患者的神经功能损害和影响生活质量,对预后无不良影响。
Objective To investigate the effect of acute period hypotensive hypotension of cerebral thrombosis on the neurological function and quality of life of patients. Methods 328 cases of first cerebral thrombosis within 48 hours after onset were randomly divided into 161 cases in the hypotensive group and 167 cases in the control group. Antihypertensive treatment was given in the hypotensive group within 24 h, with a blood pressure lowering range of 10% -25%, but not lower than 126/80 mm Hg; blood pressure <140/90 mm Hg maintained within 7 days and maintained within 14 days Level; control group not to lower blood pressure treatment. At 90 days after onset, the two groups were followed up. The improvement of neurological function and quality of life were evaluated by Modified Rankin Scale and SF-36 Health Questionnaire. Logistic regression was used to analyze the relationship between hypotensive therapy and neurological function . Results The blood pressure of the blood pressure lowering group was significantly lower than that of the control group at 1 ~ 14 d and 90 d after randomization (P <0.000 1). On the 14th and 90th days, the modified Rankin scale score [2.0 (1.0-3.0 ) And 1.0 (1.0-3.0) and SF-36 in all dimensions were not significantly different from those in the control group [2.0 (1.0-3.0) and 1.0 (1.0-3.0, respectively]] ); Logistic regression: suggestive of an acute hypotensive effect of cerebral thrombosis does not affect the neurological function of patients on the 14th and 90th days [OR = 0.98, P = 0.70; OR = 0.96, P = 0.52]. Conclusion The treatment of acute phase hypotension with cerebral thrombosis does not increase the neurological impairment and quality of life, and has no adverse effect on prognosis.