老年进展性脑梗死患者的血压动态变化及临床特点

目的探讨老年进展性脑梗死患者血压动态变化特点与疾病进展、预后的相关性。方法回顾性分析2012年6月至2013年6月承德市兴隆县人民医院内科收治的147例老年急性脑梗死患者临床资料及入院第1日、第7日动态血压变化的特点,并根据其病情进展与否分为进展组52例和非进展组95例,与同期147例健康体检者动态血压变化做比较,进展组及非进展组患者入院第30日采用改良Rankin量表进行神经功能评价,并分析其血压变化与患者预后的相关性。结果进展组夜间平均收缩压(nMBP)、夜间平均舒张压(nDBP)、夜间血压下降率、日间平均血压(dMBP)及血压昼夜节律与非进展组比较,差异有统计学意义(P<0.05),而日间平均收缩压(dSBP)、日间平均舒张压(dDBP)及24 h平均血压(24h MBP)均无统计学意义(P>0.05);24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、24 h MBP、dSBP、dDBP、nSBP、nDBP、nMBP均与Rankin量表评分呈正相关(P均<0.05)。结论动态血压监测老年急性脑梗死了解其血压变化及昼夜节律,在一定程度上,提示其疾病进展和损伤情况,评估其近期预后。

Dynamic Changes and Clinical Features of Blood Pressure of the Elderly Patients with Progressive Cerebral Infarction

Objective To investigate the correlation between dynamic variations of blood pressure with disease progression in the elderly patients with progressive cerebral infarction. Methods The clinical data and dynamic changes of blood pressure of 147 patients with acute cerebral infarction at the 1 st ,7th day admitted to hospital were analyzed retrospectively and were divided into progress group （ 52 cases） and nonprogressive group （95 cases） according to their progression, and were compared with dynamic variations of blood pressure of 147 healthy volunteers during the same period. After 30 days of hospitalization, the patients in progress and non-progressive group were evaluated with modified Rankin scale and the correlation between changes in blood pressure and prognosis was analyzed. Results The nSBP, nDBP, nighttime blood pressure decrease rate, dMBP and circadian rhythms of progress group had significant differences from the nonprogressive group （P 〈 0.05 ）, while the dSBP, dDBP and 24h mean blood pressure had no significant differences（P 〉 0.05 ）. The 24h SBP, 24h DBP, 24h MBP, dSBP, dDBP, dMBP, nSBP, nDBP, nMBP were positively correlated with Rankin scores （ all P 〈 0.05 ）. Conclusion Ambulatory blood pressure monitoring on the elderly patients with acute cerebral infarction can help to get the information of the circadian rhythm and blood pressure variations,reveal the disease progression and injury to some extent and assess the shortterm prognosis.