陕西医学杂志
陝西醫學雜誌
협서의학잡지
SHAANXI MEDICAL JOURNAL
2013年
11期
1468-1471,1472
,共5页
陈尔秀%高珩%古长维%闫中南%李丽君
陳爾秀%高珩%古長維%閆中南%李麗君
진이수%고형%고장유%염중남%리려군
卒中/病理生理学%动态血压%预后%急性病
卒中/病理生理學%動態血壓%預後%急性病
졸중/병리생이학%동태혈압%예후%급성병
Stroke/physiopathology%Ambulatory blood pressur%Prognosis%Acute disease
目的：探讨脑卒中急性期入院7d内（第1、3、7d）血压动态变化规律，血压与卒中7d预后的关系，为脑卒中急性期血压的控制及脑血流的管理提供科学依据。方法：选择ICU急性脑卒中患者41例，利用心电监护仪观测急性脑卒中动态血压变化及预后关系。结果：①脑卒中急性期血压升高，首次血压增高者约占87．1％，以收缩压升高为主，并且存在自发性下降趋势，在无特殊降压措施的情况下与第24h相比，第72h、第7d的收缩压及舒张压均有明显的下降。②出血性卒中组急性期的收缩压及舒张压显著高于缺血性卒中组。③缺血性卒中者入院时收缩压与7d预后呈U型，舒张压与7d预后呈L型，出血性卒中患者入院时收缩压与7d预后呈U型，舒张压与7d预后呈J型。结论：①脑卒中急性期多伴有血压明显升高，伴随着时间的变化有自发性下降的倾向及趋势，出血性卒中组血压要明显高于缺血性卒中组。②脑卒中急性期脑血流的自动调节功能受损。③脑出血可将血压控制在160/90～100mmHg，而脑梗死将血压控制在（160～180）/（90～100）mmHg水平为宜。
目的：探討腦卒中急性期入院7d內（第1、3、7d）血壓動態變化規律，血壓與卒中7d預後的關繫，為腦卒中急性期血壓的控製及腦血流的管理提供科學依據。方法：選擇ICU急性腦卒中患者41例，利用心電鑑護儀觀測急性腦卒中動態血壓變化及預後關繫。結果：①腦卒中急性期血壓升高，首次血壓增高者約佔87．1％，以收縮壓升高為主，併且存在自髮性下降趨勢，在無特殊降壓措施的情況下與第24h相比，第72h、第7d的收縮壓及舒張壓均有明顯的下降。②齣血性卒中組急性期的收縮壓及舒張壓顯著高于缺血性卒中組。③缺血性卒中者入院時收縮壓與7d預後呈U型，舒張壓與7d預後呈L型，齣血性卒中患者入院時收縮壓與7d預後呈U型，舒張壓與7d預後呈J型。結論：①腦卒中急性期多伴有血壓明顯升高，伴隨著時間的變化有自髮性下降的傾嚮及趨勢，齣血性卒中組血壓要明顯高于缺血性卒中組。②腦卒中急性期腦血流的自動調節功能受損。③腦齣血可將血壓控製在160/90～100mmHg，而腦梗死將血壓控製在（160～180）/（90～100）mmHg水平為宜。
목적：탐토뇌졸중급성기입원7d내（제1、3、7d）혈압동태변화규률，혈압여졸중7d예후적관계，위뇌졸중급성기혈압적공제급뇌혈류적관리제공과학의거。방법：선택ICU급성뇌졸중환자41례，이용심전감호의관측급성뇌졸중동태혈압변화급예후관계。결과：①뇌졸중급성기혈압승고，수차혈압증고자약점87．1％，이수축압승고위주，병차존재자발성하강추세，재무특수강압조시적정황하여제24h상비，제72h、제7d적수축압급서장압균유명현적하강。②출혈성졸중조급성기적수축압급서장압현저고우결혈성졸중조。③결혈성졸중자입원시수축압여7d예후정U형，서장압여7d예후정L형，출혈성졸중환자입원시수축압여7d예후정U형，서장압여7d예후정J형。결론：①뇌졸중급성기다반유혈압명현승고，반수착시간적변화유자발성하강적경향급추세，출혈성졸중조혈압요명현고우결혈성졸중조。②뇌졸중급성기뇌혈류적자동조절공능수손。③뇌출혈가장혈압공제재160/90～100mmHg，이뇌경사장혈압공제재（160～180）/（90～100）mmHg수평위의。
Objective:to study the rule of the dynamic blood pressure changes and the relationship be-tween blood pressure and cerebral blood flow in actue stroke patients who were admitted to hospital in 7days (1 ,3 ,7 days) .Provided the scientific basis for actue stroke in the blood pressure control and the management of cerebral blood flow is our purpose .Methods :In this study ,we selected 41 cases of acute stroke patients in ICU .We observed dynamic changes in blood pressure on ECG monitor and prognosis of patients .Result :①Blood Pressure elevated in initial stage of acute stroke ,Blood Pressure was increased increased about 87 .1% for the first time ,especially the systolic blood pressure ,and declined spontaneously with the time without specifically administrative drugs ,compared with the frist 24-hour after onset ,systolic blood pressure (SBP)and diastolic blood pressure (DBP) both had signifi-cantly decreased at the 3th and 7th day .②Patients with acute hemorrhagic stroke had significantly higher SBP and DBP than those with acute ischemic stroke .③There was a U-shaped relationship between admission SBP and 7-day Prognosis and L-shaped relationship between DBP and 7-day prognosis in the group of cerebral infarction ,However , In the group of cerebral hemorrhage ,we found a U-shaped relationship between admission SBP and 7-day Prognosis and J-shaped relationship between DBP and 7-day Prognosis .Conclusion :① Blood Pressure usually elevated inpa-tients with acute stroke ,and declined gradually with the time .Patients with hemorrhagic stroke has signifieantly higher SBP and DBP than those with ischemic stroke .The management of elevated blood pressure during acute sr-toke should be cautious appropriate and individualized .②Ipsilateral and contralateral side cerebral blood flow auto-regulation are proably both Damaged in acute stroke . .③ The level of blood pressure should control in160/90~100mmHg ,who is cerebral hemorrhage .And 160~180/90~100mmHg is the appropriate blood pressure ,who is cerebral Infarction .
