非重症自发性脑出血急性期血压与近期预后的关系

目的探讨非重症自发性脑出血急性期血压与近期预后的关系。方法选择168例经头颅CT证实的非重症自发性脑出血患者起病后72 h内的血压情况,应用改良的Rankin量表(mRS)对患者第21天神经功能恢复情况进行评分并分组,mRS≥4分组(64例)和mRS4分组(104例),并进行回归分析。结果与mRS4分组比较,mRS≥4分组患者急性期收缩压、舒张压、平均动脉压(MAP)均明显升高,差异有统计学意义(P0.05)。与MAP≤120 mm Hg(1 mm Hg=0.1 33 kPa)患者比较,MAP120 mm Hg患者预后明显差(OR=2.593,95% CI:1.324～5.078,P=0.005)。MAP是近期预后差的独立危险因素(OR=1.025,95% CI:1.007～1.044,P=0.008)。结论非重症自发性脑出血急性期血压与近期预后密切相关,MAP升高是近期预后差的独立危险因素之一。

Relationship between blood pressure and short-term outcome in non-severe spontaneous intracerebral hemorrhage

Objective To explore the relationship between blood pressure and short-term outcome in non-severe spontaneous intracerebral hemorrhage.Methods 168 patients who had spontaneous intracerebral hemorrhage diagnosed by CT were assessed retrospectively.Records of blood pressure within 72 hours of onset in acute phase and modified Rankin Scale(mRS) scores on 21st day were assessed.Poor outcome was defined as mRS≥4.Results mRS≥4 occurred in 64 patients. SBP,DBP and MAP in the group of mRS≥4 were obviously higher than those in group of mRS< 4 (P < 0.05).The outcome in the group of MAP>120 mm Hg was significantly poorer than that in MAP<120 mm Hg (OR = 2.593,95% CI:1.324-5.078,P = 0.005).A logistic regression model for predicting poor outcome was constructed using MAP,sex,age,blood entering cerebral ventricle,hematoma position and previously documented hypertension.After adjustment for these factors,MAP was independently associated with poor outcome (OR = 1.025,95% CI :1.007 — 1.044,P = 0.008).Conclusion Elevated blood pressure in acute phase of non-severe spontaneous intracerebral hemorrhage is closely associated with poor outcome.MAP>120 mm Hg in acute phase predicts short-term poor outcome.