中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2006年
12期
167-169
,共3页
脑梗塞%血压测定%因素分析,统计学
腦梗塞%血壓測定%因素分析,統計學
뇌경새%혈압측정%인소분석,통계학
背景:认识血压的不同成分对脑血管病的影响及在疾病不同情况下正确使用降压治疗均具有重要意义.目的:通过对急性脑梗死患者的入院脉压分析,探讨脉压增大与脑梗死的发生、严重程度的相关性.设计:病例-对照分析.单位:哈尔滨医科大学附属第一医院.对象:病例组为2002-06/2003-01因缺血性脑梗死入住哈尔滨医科大学附属第一医院的患者300例,男196例,女104例;年龄(57.9±11.9)岁.正常组为在同期来本院进行体检者199例,男110例,女89例;年龄(55.9±12.4)岁.方法:①血压测量:安静状态下应用水银柱血压计按标准方法选择右上肢肱动脉处测血压.记录患者的收缩压和舒张压,并计算脉压.②神经功能缺损评分:应用美国国立卫生研究院卒中量表在入院时对每例缺血性脑梗死患者进行临床神经功能缺损评分,以入院时评分作为脑卒中严重程度的评价指标,分值越大,脑卒中程度越重.主要观察指标:①两组对象血压各参数比较.②两组对象中不同脉压水平人员分布情况.③两组中不同年龄段人群脉压比较.④不同脉压水平脑梗死患者神经功能缺失评分非参数检验结果.结果:①平均收缩压:病例组明显高于对照组[(152±22),(133±19)mm Hg,t'=10.494,P＜0.01].平均舒张压:病例组明显高于对照组[(93±14),(81±11)mmHg,t'=10.129,P＜0.01].平均脉压:病例组脉压高于对照组[(59.61±11.86),(51.93±14.10)mm Hg,t'=5.612,P＜0.05].两两相关分析结果显示,脉压与收缩压的Pearson相关系数为0.789(P＜0.01),脉压与舒张压的Pearson相关系数为0.169(P＜0.01),故可以认为脉压与收缩压的相关性更密切.②在病例组,脉压最大的分布区域在60～69mm Hg,占27.7%;对照组脉压最大的分布区域在40～49 mm Hg,占35.7%.提示脑梗死时脉压大于60mm Hg的发生率较高.③随着年龄的增加,脉压增大.40～69岁病例组的脉压水平明显高于同年龄对照组[(54±16),(45±9)mm Hg,t=4.86,P=0.000].④不同脉压水平脑梗死患者进行入院神经功能缺失评分的非参数检验,结果为Kruskal-Wallis检验统计量如下:x2=4.779,P=0.572＞0.05;中位数检验的检验统计量如下:x2=8.365,P=0.213＞0.05.两种非参数检验结果提示入院评分差异无显著性,也就是说脑梗死时虽然脉压明显升高,但脉压增高的程度与神经功能缺失的严重程度无关.结论:脉压的增大与脑梗死的发生有关,是脑梗死发生的重要评价因素,但脉压的变化并不与脑梗死的严重程度相关.
揹景:認識血壓的不同成分對腦血管病的影響及在疾病不同情況下正確使用降壓治療均具有重要意義.目的:通過對急性腦梗死患者的入院脈壓分析,探討脈壓增大與腦梗死的髮生、嚴重程度的相關性.設計:病例-對照分析.單位:哈爾濱醫科大學附屬第一醫院.對象:病例組為2002-06/2003-01因缺血性腦梗死入住哈爾濱醫科大學附屬第一醫院的患者300例,男196例,女104例;年齡(57.9±11.9)歲.正常組為在同期來本院進行體檢者199例,男110例,女89例;年齡(55.9±12.4)歲.方法:①血壓測量:安靜狀態下應用水銀柱血壓計按標準方法選擇右上肢肱動脈處測血壓.記錄患者的收縮壓和舒張壓,併計算脈壓.②神經功能缺損評分:應用美國國立衛生研究院卒中量錶在入院時對每例缺血性腦梗死患者進行臨床神經功能缺損評分,以入院時評分作為腦卒中嚴重程度的評價指標,分值越大,腦卒中程度越重.主要觀察指標:①兩組對象血壓各參數比較.②兩組對象中不同脈壓水平人員分佈情況.③兩組中不同年齡段人群脈壓比較.④不同脈壓水平腦梗死患者神經功能缺失評分非參數檢驗結果.結果:①平均收縮壓:病例組明顯高于對照組[(152±22),(133±19)mm Hg,t'=10.494,P＜0.01].平均舒張壓:病例組明顯高于對照組[(93±14),(81±11)mmHg,t'=10.129,P＜0.01].平均脈壓:病例組脈壓高于對照組[(59.61±11.86),(51.93±14.10)mm Hg,t'=5.612,P＜0.05].兩兩相關分析結果顯示,脈壓與收縮壓的Pearson相關繫數為0.789(P＜0.01),脈壓與舒張壓的Pearson相關繫數為0.169(P＜0.01),故可以認為脈壓與收縮壓的相關性更密切.②在病例組,脈壓最大的分佈區域在60～69mm Hg,佔27.7%;對照組脈壓最大的分佈區域在40～49 mm Hg,佔35.7%.提示腦梗死時脈壓大于60mm Hg的髮生率較高.③隨著年齡的增加,脈壓增大.40～69歲病例組的脈壓水平明顯高于同年齡對照組[(54±16),(45±9)mm Hg,t=4.86,P=0.000].④不同脈壓水平腦梗死患者進行入院神經功能缺失評分的非參數檢驗,結果為Kruskal-Wallis檢驗統計量如下:x2=4.779,P=0.572＞0.05;中位數檢驗的檢驗統計量如下:x2=8.365,P=0.213＞0.05.兩種非參數檢驗結果提示入院評分差異無顯著性,也就是說腦梗死時雖然脈壓明顯升高,但脈壓增高的程度與神經功能缺失的嚴重程度無關.結論:脈壓的增大與腦梗死的髮生有關,是腦梗死髮生的重要評價因素,但脈壓的變化併不與腦梗死的嚴重程度相關.
배경:인식혈압적불동성분대뇌혈관병적영향급재질병불동정황하정학사용강압치료균구유중요의의.목적:통과대급성뇌경사환자적입원맥압분석,탐토맥압증대여뇌경사적발생、엄중정도적상관성.설계:병례-대조분석.단위:합이빈의과대학부속제일의원.대상:병례조위2002-06/2003-01인결혈성뇌경사입주합이빈의과대학부속제일의원적환자300례,남196례,녀104례;년령(57.9±11.9)세.정상조위재동기래본원진행체검자199례,남110례,녀89례;년령(55.9±12.4)세.방법:①혈압측량:안정상태하응용수은주혈압계안표준방법선택우상지굉동맥처측혈압.기록환자적수축압화서장압,병계산맥압.②신경공능결손평분:응용미국국립위생연구원졸중량표재입원시대매례결혈성뇌경사환자진행림상신경공능결손평분,이입원시평분작위뇌졸중엄중정도적평개지표,분치월대,뇌졸중정도월중.주요관찰지표:①량조대상혈압각삼수비교.②량조대상중불동맥압수평인원분포정황.③량조중불동년령단인군맥압비교.④불동맥압수평뇌경사환자신경공능결실평분비삼수검험결과.결과:①평균수축압:병례조명현고우대조조[(152±22),(133±19)mm Hg,t'=10.494,P＜0.01].평균서장압:병례조명현고우대조조[(93±14),(81±11)mmHg,t'=10.129,P＜0.01].평균맥압:병례조맥압고우대조조[(59.61±11.86),(51.93±14.10)mm Hg,t'=5.612,P＜0.05].량량상관분석결과현시,맥압여수축압적Pearson상관계수위0.789(P＜0.01),맥압여서장압적Pearson상관계수위0.169(P＜0.01),고가이인위맥압여수축압적상관성경밀절.②재병례조,맥압최대적분포구역재60～69mm Hg,점27.7%;대조조맥압최대적분포구역재40～49 mm Hg,점35.7%.제시뇌경사시맥압대우60mm Hg적발생솔교고.③수착년령적증가,맥압증대.40～69세병례조적맥압수평명현고우동년령대조조[(54±16),(45±9)mm Hg,t=4.86,P=0.000].④불동맥압수평뇌경사환자진행입원신경공능결실평분적비삼수검험,결과위Kruskal-Wallis검험통계량여하:x2=4.779,P=0.572＞0.05;중위수검험적검험통계량여하:x2=8.365,P=0.213＞0.05.량충비삼수검험결과제시입원평분차이무현저성,야취시설뇌경사시수연맥압명현승고,단맥압증고적정도여신경공능결실적엄중정도무관.결론:맥압적증대여뇌경사적발생유관,시뇌경사발생적중요평개인소,단맥압적변화병불여뇌경사적엄중정도상관.
BACKGROUND: It is of great significance to understand the effects of different components of blood pressure on the occurrence of cerebrovascular diseases and administer proper decompression treatments in various situations.OBJECTIVE: To study the relationship of increased pulse pressure with the occurrence and severity degree of cerebral infarction by analyzing the data of pulse pressure recorded in hospitalized patients with acute cerebral infarction.DESIGN: Case-control analysis.SETTING: First Affiliated Hospital of Harbin Medical University.PARTICIPANTS: A total of 300 patients hospitalized at the First Affiliated Hospital of Harbin Medical University between June 2002 and January 2003 for ischemic cerebral infarction were enrolled, including 196males and 104 females aged (57.9±11.9) years. Another 199 persons who came to the same hospital for physical examination at the same period were set as normal group, including 110 males and 89 females aged (55.9±12.4)years.METHODS: ① Measurement of blood pressure: Systolic pressure and diastolic pressure of each person were recorded with mercury sphygmomanometer at the site of brachial artery of the right upper extremity and pulse pressure was calculated. ② Evaluation of neurological impairment:Upon hospital admission, each patient with ischemic cerebral infarction was evaluated with the stroke scale made by the National Institute of Health (NIHSS), in which a higher score means more severe infarction.MAIN OUTCOME MEASURES: ① Comparison of blood pressure parameters of subjects in the two groups. ② Distribution of different pulse pressure levels in the two groups. ③ Comparison of pulse pressure of subjects of different age in the two groups. ④ Results of non-parameters tests of neural function loss in cerebral infarction patients with different pulse pressure levels.RESULTS: ① Mean systolic pressure: It was significantly higher in the case group than in control group [(152±22), (133±19) mm Hg, t' =10.494,P ＜ 0.01]. Mean diastolic pressure: It was higher in the case group than in control group [(93±14), (81±11) mm Hg, t' = 10.129, P ＜ 0.01]. Meanpulse pressure: It was higher in the case group than in control group [(59.61±11.86), (51.93±14.10) mm Hg, t' =5.612, P ＜ 0.05]. Pairwise corre lation analysis showed that Pearson correlation coefficient between pulse pressure and systolic pressure was 0.789 (P ＜ 0.01); Pearson correlation.coefficient between pulse pressure and diastolic pressure was 0.169 (P ＜ 0.01). Therefore, there was a close correlation between pulse pressure and systolic pressure. ② Pulse pressure was distributed between 60 mm Hg and 69 mm Hg in most subjects in the case group, which accounted for 27.7%.It was 40-49 mm Hg in control group, which accounted for 35.7%. It indicated that the incidence rate was high when the pulse pressure was over 60 mm Hg in cerebral infarction. ③ Pulse pressure increased with age.The level of pulse pressure in 40-69 years case group was higher than that in 40-69 control group [(54±16), (45±9)mm Hg, t=4.86, P=0.000]. ④ Patients with cerebral infarction of different levels of pulse pressure were given non-parameter tests of neurological impairment evaluation. The resuits of Kruskal-Wallis test were χ2=4.779, P=0.572 ＞ 0.05; results of median test were as x2=8.365, P=0.213 ＞ 0.05. The results of the two non-parameter tests suggested that there was no significant differences in hospitalization evaluation, that is, although the pulse pressure increased obviously in cerebral infarction, the degree of increase had no correlation with the severity of neurological impairment.CONCLUSION: The increase of pulse pressure is related to the occurrence of cerebral infarction and is also an important factor for evaluating cerebral infarction. However, pulse pressure change is not related to the severity of cerebral infarction.
