急性缺血性脑卒中患者静脉溶栓后血压变异性与预后相关性的研究进展

静脉溶栓后短时血压变异性（BPV）是急性缺血性脑卒中患者症状性颅内出血、预后不良以及死亡的重要因素。静脉溶栓后“血压骤降”可能预示着血管再通。短时BPV主要通过影响缺血半暗带组织周边的持续性脑血流供应来影响脑卒中的预后。目前多数研究表明,静脉溶栓后收缩压维持在141~150 mm Hg可能有利于改善脑卒中患者的预后,但缺血性脑卒中患者静脉溶栓后的最佳血压管理方案尚未确定,尤其是降压指征和幅度方面,仍存在很大争议。本文主要就急性缺血性脑卒中患者静脉溶栓后BPV与预后的相关性进行综述。

Latest Advances in Blood Pressure Variability and Prognosis in Patients with Ischemic Stroke after Intravenous Thrombolysis

Short-term blood pressure variability （BPV） after intravenous thrombolysis is an important factor for symptomatic intracranial hemorrhage,poor prognosis and death in patients with acute ischemic stroke.A "sudden drop" in blood pressure may indicate recanalization after intravenous thrombolysis.Short-term BPV may affect the prognosis of stroke by affecting the continuous cerebral blood flow supply around ischemic penumbra.At present,most studies show that maintaining post-thrombolysis systolic blood pressure at 141-150 mm Hg may be beneficial to improve the prognosis of patients with stroke.However,the optimal blood pressure management for patients with ischemic stroke after intravenous thrombolysis has not been determined,especially the indication and extent of depressurization,which is still a great controversy.This article reviews the BPV and prognosis in patients with ischemic stroke after intravenous thrombolysis.