Stroke:血管内血栓切除术后的血压变异性与神经功能结局

2019-12-09 xing.T MedSci原创

由此可见,在接受EVT治疗的卒中患者中,发病24小时内较高的BPV与90天预后较差有关。这种关联对于收缩期BPV更稳健。BPV可能对神经系统结局产生负面影响的机制仍未明确,但是这种关联的一致性值得进一步研究。

尽管较高的血压变异性(BPV)与卒中后较差的功能预后相关,但在采取血管内治疗(EVT)的大血管阻塞性卒中患者中,这种关联尚未明确。

近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,缺血性卒中患者血管内治疗血压情况(BEST)是一项前瞻性、多中心队列研究,参与者为接受EVT的前循环急性缺血性卒中患者,研究人员确定了BPV与不良预后或死亡(90天改良Rankin量表为3–6)之间的关联。研究人员使用5种方法计算了EVT后24小时内收缩压和舒张压的BPV,然后将BPV分为三分位数,并使用logistic回归比较了最高三分位数与最低三分位数。

在该分析的443例患者中,259例(58.5%)患者预后较差,79例(17.8%)患者死亡。在结局较差或死亡的患者中,BPV的所有指标均显著较高,但收缩压BPV的差异比舒张压BPV更为明显。在Logistic回归中,收缩压BPV的最高三分位数可始终预示不良结局(比值比为1.8-3.5,所有P<0.05)。在收缩压BPV最低三分位数个体中,90天之内的死亡率为10.1%,而在BPV最高的三分位数个体中,死亡率为25.2%(P<0.001)。

由此可见,在接受EVT治疗的卒中患者中,发病24小时内较高的BPV与90天预后较差有关。这种关联对于收缩期BPV更稳健。BPV可能对神经系统结局产生负面影响的机制仍未明确,但是这种关联的一致性值得进一步研究。 

原始出处:

Eva A. Mistry.et al.Blood Pressure Variability and Neurologic Outcome After Endovascular Thrombectomy A Secondary Analysis of the BEST Study.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.027549

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    2019-12-10 心介

    #血压变异性#相信未来5年是热点,不仅关心血压高与低,还要关注血压变异性才可以

    0

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