Eur Heart J:缺血性卒中患者的血压和住院预后之间的相关性分析!

2017-07-03 xing.T MedSci原创

在入院缺血性脑卒中住院患者中,可以观察到血压与短期结局之间存在J形或U形的关系。溶栓治疗后出血并发症随血压降低而较低。

卒中高血压与较差的短期预后相关,尽管这些结果相互矛盾。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员的目标是评估急性缺血性卒中患者血压与住院预后之间的相关性。

该研究纳入了急性缺血性卒中患者,入院时收缩压和舒张压被用于计算平均动脉压(MAP)和脉压(PP)。该研究感兴趣的结局是:住院期间的死亡率、不能出院回家、不能独立走动以及溶栓治疗的出血并发症。

该研究共纳入了309611例缺血性卒中患者,研究人员发现收缩压和结局之间存在J形或U形关系。较低和较高的收缩压,与中间参考值进行比较,均有较高的住院期间死亡的风险[例如调整后的比值比(95%可信区间)(对于120 vs. 150mmHg的OR[95%CI]=1.16[1.13-1.20];对于150 vs. 200mmHg的OR为1.24[1.19-1.30] )、不能出院回家(对于120 vs. 150mmHg的OR[95%CI]=1.11[1.09-1.13] ;对于150 vs. 200mmHg的OR为1.15 [1.12-1.18] )、不能独立行走(对于120 vs. 150mmHg的OR[95%CI]=1.16[1.13-1.18];对于150 vs. 200mmHg的OR为1.09 [1.06-1.11])。然而,溶栓治疗的出血并发症风险因收缩压降低而较低(对于120 vs. 150mmHg的OR[95%CI]=0.89[0.83-0.97]),而因较高的收缩压升高(对于150 vs. 200mmHg的OR[95%CI]=1.21[1.11-1.32])。这些结果在很大程度上与入院舒张压、MAP和PP是相似的。

在入院缺血性脑卒中住院患者中,可以观察到血压与短期结局之间存在J形或U形的关系。溶栓治疗后出血并发症随血压降低而较低。

原始出处:

Sripal Bangalore,et al. Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke. Eur Heart J. https://doi.org/10.1093/eurheartj/ehx330

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content=好大的样本啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Tue Jul 04 06:56:44 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1837290, encodeId=0d00183e290b0, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Mar 23 06:30:00 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010369, encodeId=6d14201036998, content=<a href='/topic/show?id=9cf7e9360d2' target=_blank style='color:#2F92EE;'>#缺血性卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79360, encryptionId=9cf7e9360d2, topicName=缺血性卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=/img/user_icon.png, createdBy=1072181, createdName=wjywjy, createdTime=Thu Jul 13 19:30:00 CST 2017, time=2017-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806163, encodeId=97b4180616365, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Wed May 02 14:30:00 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892896, encodeId=434d1892896a2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, 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encodeId=700915626108e, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Jul 05 00:30:00 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218409, encodeId=4c2621840931, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Jul 04 08:15:07 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218363, encodeId=b482218363b0, content=好大的样本啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Tue Jul 04 06:56:44 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1837290, encodeId=0d00183e290b0, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Mar 23 06:30:00 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010369, encodeId=6d14201036998, content=<a href='/topic/show?id=9cf7e9360d2' target=_blank style='color:#2F92EE;'>#缺血性卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79360, encryptionId=9cf7e9360d2, topicName=缺血性卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=/img/user_icon.png, createdBy=1072181, createdName=wjywjy, createdTime=Thu Jul 13 19:30:00 CST 2017, time=2017-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806163, encodeId=97b4180616365, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Wed May 02 14:30:00 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1892896, encodeId=434d1892896a2, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Sun Mar 11 09:30:00 CST 2018, time=2018-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720185, encodeId=49921e20185b3, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=940232842333, createdName=wangyang7969, createdTime=Sun Apr 22 21:30:00 CST 2018, time=2018-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356390, encodeId=b737135639010, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Jul 05 00:30:00 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1523538, encodeId=126c15235388b, content=<a href='/topic/show?id=f6f1e2533e3' target=_blank style='color:#2F92EE;'>#相关性分析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72533, encryptionId=f6f1e2533e3, topicName=相关性分析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad8f11536374, createdName=anminleiryan, createdTime=Wed Jul 05 00:30:00 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562610, encodeId=700915626108e, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Jul 05 00:30:00 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218409, encodeId=4c2621840931, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Jul 04 08:15:07 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218363, encodeId=b482218363b0, content=好大的样本啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Tue Jul 04 06:56:44 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
    2017-07-05 zhaojie88
  7. 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  8. 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encodeId=700915626108e, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Wed Jul 05 00:30:00 CST 2017, time=2017-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218409, encodeId=4c2621840931, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=162, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Jul 04 08:15:07 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218363, encodeId=b482218363b0, content=好大的样本啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Tue Jul 04 06:56:44 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
    2017-07-05 slcumt
  9. 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content=好大的样本啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Tue Jul 04 06:56:44 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
    2017-07-04 meiliwuxian

    学习了

    0

  10. 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content=好大的样本啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Tue Jul 04 06:56:44 CST 2017, time=2017-07-04, status=1, ipAttribution=)]
    2017-07-04 baihao215

    好大的样本啊

    0

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