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目的评估血压对脑梗塞急性期预后神经功能恢复的影响,使血压的影响降低到最低。方法脑梗塞患者400例根据有无高血压分为观察组150例和对照组250例,观察两组在治疗前的24h平均收缩压变异性(SB-PV)、24h平均舒张压变异性(DBPV)和三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)含量。使用美国国立卫生研究院梗塞量表(NIHSS)评价神经功能恢复,记录治疗前,治疗后第7d,第28d的NIHSS评分。结果观察组的SBPV、DBPV都明显高于对照组(P<0.05),而两组TG、TC、LDL之间均差异无统计学意义(P>0.05)。两组治疗前的NIHSS评分无显著性差异,经过治疗后,都随着时间的变化明显下降(P<0.05),但是观察组的治疗后第7d及第28d时NIHSS评分都明显低于对照组(P<0.05)。结论血压过高能使脑梗塞急性期的血压波动幅度过大,对于血脂无明显影响,同时能严重影响患者神经功能的恢复,值得在临床上观察注意。
Objective To evaluate the effect of blood pressure on the recovery of neurological function in acute stage of cerebral infarction and to minimize the influence of blood pressure. Methods 400 patients with cerebral infarction were divided into observation group (150 cases) and control group (250 cases) according to the presence or absence of hypertension. 24h mean systolic pressure variability (SB-PV), 24h mean diastolic variability (DBPV ) And triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) content. NIHSS was used to assess neurological function recovery. NIHSS scores were recorded before treatment, on day 7 and day 28 after treatment. Results The SBPV and DBPV in the observation group were significantly higher than those in the control group (P <0.05). There was no significant difference between the two groups in TG, TC and LDL (P> 0.05). There was no significant difference in the NIHSS scores between the two groups before treatment, after treatment, they all decreased significantly with time (P <0.05), but NIHSS scores of the observation group were significantly lower than those of the control group on the 7th and 28th day (P <0.05). Conclusions High blood pressure can make the blood pressure fluctuation in the acute phase of cerebral infarction too large, which has no obvious effect on the blood lipids, meanwhile it can seriously affect the recovery of neurological function in patients with cerebral infarction. It is worth to pay attention to the clinical observation.