中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
21期
2419-2421,2422
,共4页
何奕涛%蔡智立%马可夫%唐冰杉%郭毅
何奕濤%蔡智立%馬可伕%唐冰杉%郭毅
하혁도%채지립%마가부%당빙삼%곽의
脑梗死%进展性缺血性卒中%颈动脉疾病%血压晨峰
腦梗死%進展性缺血性卒中%頸動脈疾病%血壓晨峰
뇌경사%진전성결혈성졸중%경동맥질병%혈압신봉
Braininfarction%Progressiveischemicstroke%Carotidarterydiseases%Morningbloodpressuresurge
目的：探讨血压晨峰与进展性缺血性卒中（PIS）的相关性。方法选取2012年10月-2013年10月本院神经内科收治的急性缺血性卒中患者240例，根据欧洲进展性卒中研究组对进展性卒中的诊断标准，将患者分为进展性卒中组及非进展性卒中组。对患者导致PIS的相关危险因素进行单因素及多因素分析，并比较血压晨峰升高患者与非血压晨峰升高患者中PIS发生率。结果240例急性缺血性卒中患者中，进展性卒中组72例（30.0％），非进展性卒中组168例（70.0％）。进展性卒中组患者血压晨峰值、平均动脉压、血浆纤维蛋白原水平及高脂血症、发病1周内感染、颅内动脉狭窄、颈内动脉狭窄、心房纤颤发生率均高于非进展性卒中组（ P＜0.05）。血压晨峰升高患者PIS的发生率高于非血压晨峰升高患者〔55.0％（44/80）与17.5％（28/160），χ2＝8.929， P＝0.003〕。进一步以是否发生PIS为因变量，经二元逐步Logistic回归分析，发现血压晨峰升高、血浆纤维蛋白原水平升高、颅内动脉狭窄及心房纤颤是PIS的独立危险因素（ P＜0.05）。结论血压晨峰升高的缺血性卒中患者PIS发生率升高，而且血压晨峰升高是导致PIS的独立危险因素。
目的：探討血壓晨峰與進展性缺血性卒中（PIS）的相關性。方法選取2012年10月-2013年10月本院神經內科收治的急性缺血性卒中患者240例，根據歐洲進展性卒中研究組對進展性卒中的診斷標準，將患者分為進展性卒中組及非進展性卒中組。對患者導緻PIS的相關危險因素進行單因素及多因素分析，併比較血壓晨峰升高患者與非血壓晨峰升高患者中PIS髮生率。結果240例急性缺血性卒中患者中，進展性卒中組72例（30.0％），非進展性卒中組168例（70.0％）。進展性卒中組患者血壓晨峰值、平均動脈壓、血漿纖維蛋白原水平及高脂血癥、髮病1週內感染、顱內動脈狹窄、頸內動脈狹窄、心房纖顫髮生率均高于非進展性卒中組（ P＜0.05）。血壓晨峰升高患者PIS的髮生率高于非血壓晨峰升高患者〔55.0％（44/80）與17.5％（28/160），χ2＝8.929， P＝0.003〕。進一步以是否髮生PIS為因變量，經二元逐步Logistic迴歸分析，髮現血壓晨峰升高、血漿纖維蛋白原水平升高、顱內動脈狹窄及心房纖顫是PIS的獨立危險因素（ P＜0.05）。結論血壓晨峰升高的缺血性卒中患者PIS髮生率升高，而且血壓晨峰升高是導緻PIS的獨立危險因素。
목적：탐토혈압신봉여진전성결혈성졸중（PIS）적상관성。방법선취2012년10월-2013년10월본원신경내과수치적급성결혈성졸중환자240례，근거구주진전성졸중연구조대진전성졸중적진단표준，장환자분위진전성졸중조급비진전성졸중조。대환자도치PIS적상관위험인소진행단인소급다인소분석，병비교혈압신봉승고환자여비혈압신봉승고환자중PIS발생솔。결과240례급성결혈성졸중환자중，진전성졸중조72례（30.0％），비진전성졸중조168례（70.0％）。진전성졸중조환자혈압신봉치、평균동맥압、혈장섬유단백원수평급고지혈증、발병1주내감염、로내동맥협착、경내동맥협착、심방섬전발생솔균고우비진전성졸중조（ P＜0.05）。혈압신봉승고환자PIS적발생솔고우비혈압신봉승고환자〔55.0％（44/80）여17.5％（28/160），χ2＝8.929， P＝0.003〕。진일보이시부발생PIS위인변량，경이원축보Logistic회귀분석，발현혈압신봉승고、혈장섬유단백원수평승고、로내동맥협착급심방섬전시PIS적독립위험인소（ P＜0.05）。결론혈압신봉승고적결혈성졸중환자PIS발생솔승고，이차혈압신봉승고시도치PIS적독립위험인소。
ObjectiveTodiscussthecorrelationbetweenmorningbloodpressuresurgeandprogressiveischemic stroke.Methods 240patientswithacutecerebralinfarctionadmittedtotheneurologydepartmentfromOctober2012toOctober 2013 were divided into progressive ischemic stroke group and non -progressive ischemic stroke group according to the diagnosis criteria of progressive stroke enacted by European Progressing Stroke Study Group .Single and multiple factors analysis on risk fac-tors of progressive ischemic stroke between the two groups were made and the incidence of progressive ischemic stroke was com -pared between higher and normal morning blood pressure surge .Results Among the 240 patients of acute ischemic stroke , 72 (30.0%) were in progressive ischemic stroke group and 168 (70.0%) were in non-progressive ischemic stroke.The value of morning blood pressure surge , mean arterial pressure , plasma fibrinogen and the incidences of hyperlipidaemia , infections within one week, intracranial arterial stenosis , internal carotid artery stenosis and atrial fibrillation in progressive ischemic stroke group were all higher than the non -progressive ischemic stroke group (P<0.05) .The incidence of progressive ischemic stroke in pa-tients with higher morning blood pressure surge was higher than patients with normal morning blood pressure surge 〔55.0% (44/80) vs.17.5% (28/160), χ2 =8.929, P=0.003〕 .Binary multivariable Logistic regression analysis with progressive ische-mic stroke as dependent variable showed that the value of morning blood pressure surge , plasma fibrinogen and the incidence of intracranial arterial stenosis, artrial fibrillation were independent risk factors of progressive ischemic stroke (P<0.05).Con-clusion The incidence of progressive ischemic stroke is higher in patients with ischemic stroke who have elevated morning blood pressure surge , and the elevated morning blood pressure surge was independent risk factor for progressive ischemic stroke .
