Stroke: 青年缺血性卒中患者,急性期血压升高与卒中复发相关

2016-06-01 MedSci MedSci原创

背景:急性脑卒中患者血压(BP)升高与预后不良有关,但尚未在年轻人中进行研究。方法:在赫尔辛基青年卒中记录中招募15岁到49岁首发缺血性卒中的患者,评估1004例患者BP和长期预后的相关性。BP参数入院和24h时收缩压(SBP)和舒张压、脉压和平均动脉压。主要预后指标为在长期的随访中卒中复发。校正人口学和已经存在的合并症,采用Cox回归模型评估BP参数和预后的相关性。结果:在研究的患者中(男63%

背景:急性脑卒中患者血压(BP)升高与预后不良有关,但尚未在年轻人中进行研究。

方法:在赫尔辛基青年卒中记录中招募15岁到49岁首发缺血性卒中的患者,评估1004例患者BP和长期预后的相关性。BP参数入院和24h时收缩压(SBP)和舒张压、脉压和平均动脉压。主要预后指标为在长期的随访中卒中复发。校正人口学和已经存在的合并症,采用Cox回归模型评估BP参数和预后的相关性。

结果:在研究的患者中(男63%例),393例(39%)在卒中前有高血压,358例(36%)使用抗高血压药物治疗。随访的中位数为8.9年(四分位距:5.7-13.2)。与卒中未复发的患者相比,卒中复发的患者(n = 142,14%),入院时收缩压、舒张压、脉压、平均动脉压和24h收缩压、舒张压和平均动脉压均较高。在随访期间,收缩压≥160毫米汞柱比收缩压<160 mm Hg的患者卒中复发率较高(HR 3.3 [ 95%CI,2.05-4.55 ]),并且卒中复发更早(13.9年13.0-14.6 ] vs 16.2年 [ 15.8-16.6 ])。在多变量分析中,高入院收缩压、舒张压、脉压、平均动脉压与脑卒中复发的风险独立相关,24小时血压水平与卒中复发不相关。

结论:在青年缺血性脑卒中患者中,急性期血压水平升高与卒中复发的高风险相关。

原始出处:

Mustanoja S, Putaala J, et al. Acute-Phase Blood Pressure Levels Correlate With a High Risk of Recurrent Strokes in Young-Onset Ischemic Stroke. Stroke. 2016 Jun;

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    2016-10-13 ylzr123

    学习了,好文值得点赞!

    0

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    2016-10-19 feifers
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