急性脑卒中患者血压特点的分析

目的研究急性脑卒中患者血压影响因素及动态血压特点。方法82例发病在7天内的急性脑卒中患者。记录患者住院诊室血压及24 h动态血压。血压≥140/90 mm Hg(1 mm Hg=0.133 kPa)为诊室血压升高;24 h动态血压平均值≥130/80 mm Hg、日间平均值≥135/85 mm Hg、夜间平均值≥125/75 mm Hg为动态血压升高。结果既往高血压病史对急性脑卒中患者诊室血压升高有影响(P<0.05)。有高血压病史者平均诊室血压(146.02±18.89)/(86.36±11.52)mm Hg,无高血压病史者平均诊室血压(136.22±14.63)/(82.61±11.86)mm Hg,二者收缩压水平差异有显著性意义(P<0.05)。急性脑卒中患者动态血压表现为夜间血压负荷增加,24 h平均血压于发病后4~5天明显升高,6~7天降低。诊室血压升高与诊室血压正常比较,血压形态均以非杓形和反杓形为主,2组差异无显著性意义(P>0.05)。结论急性脑卒中诊室血压升高与高血压病史有关,急性脑卒中随发病时间延长,血压呈下降趋势。

Characteristics of the blood pressure in acute stroke patients

Objective To study the factors influencing blood pressure and characteristics of 24-hour ambulatory blood pressure(ABP)in acute stroke patients.Methods Eighty-two patients who were admitted to the hospital after an acute stroke(within 7 days after onset of disease) were included in the study.The patients′ office blood pressure(OBP)and ABP were recorded as soon as possible.The OBP(≥140/90 mm Hg,1 mm Hg=(0.133) kPa) was high blood pressure.The ABPs(mean ABP≥130/80 mm Hg,mean day ABP≥135/85 mm Hg,mean night ABP ≥125/75 mm Hg) were high ABPs.Results The history of hypertension was correlated with the levels of office blood pressure in acute stroke patients(P<0.05).The mean OBPs were(146.02±18.89)/(86.36±11.52) mm Hg and(136.22±14.63)/(82.61±11.86) mm Hg in patients with and without hypertension history respectively,and the systolic blood pressures were markedly different(P<0.05).The ABP showed high night blood pressure,and the levels of ABP were relatively high in 4～5days and fell in 6～7days.The shapes of ABP were primarily non-dipper and reverse-dipper in both high OBP group and normal OBP group(P>0.05).Conclusions The high blood pressure in acute stroke patients is correlated with history of hypertension.The levels of blood pressure trend to decline as time goes on after onset of stroke.