Stroke:24小时血压变异性与收缩压对卒中溶栓结局的交互作用分析!

2017-05-26 xing.T MedSci原创

该研究表明在BP治疗前和急性BP变化过程中(即,BPV)需要更加个性化的血压管理,以使患者达到最好的可能结局。

在急性脑卒中治疗中血压(BP)改变的意义及处理尚不清楚。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在探讨24小时血压变异性(BPV)对静脉溶栓治疗的急性缺血性脑卒中患者结局的影响。

研究人员对28976例患者治疗前2小时和24小时的收缩压进行分析。该研究的BP变异的主要指标为连续变异。采用精确匹配数据进行预处理。研究人员采用了二元和有序回归分析评估了早期的神经功能改善情况、症状性颅内出血(SICH)和长期功能预后(90天改良Rankin量表[mRS])。

研究人员试图解释入院时血压变异性分析的连续变化与患者特征发现收缩压(5.5%的变异)是最有影响力的,而92%的BPV的差异仍然无法解释。独立于收缩压,分析BPV的连续变异与较差的功能结局mRS为0-2分(比值比[OR]为0.94;95%可信区间[CI]为0.90-0.98)、死亡率(OR为1.10;95%CI为1.01-1.08)、SICHsits(OR为1.14;95%CI为1.06-1.23)和SICHecass(OR为1.24;95%CI为1.10-1.40;ECASS[欧洲急性卒中协作研究2])。分析BPV的连续变化作为一个功能的预处理,收缩压可以显著改善功能结局的预测(mRS评分为0-1分、mRS评分为0-2分,神经功能改善,mRS的转变:所有相互作用P<0.01)。在的敏感性分析中排除了房颤患者,得到了一致的结果。

该研究表明在BP治疗前和急性BP变化过程中(即,BPV)需要更加个性化的血压管理,以使患者达到最好的可能结局。

原始出处:

Lars Kellert,  et al. Reciprocal Interaction of 24-Hour Blood Pressure Variability and Systolic Blood Pressure on Outcome in Stroke Thrombolysis.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.117.016876

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    2017-06-08 chengjn
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    2017-05-28 ylz8405
  5. [GetPortalCommentsPageByObjectIdResponse(id=1840306, encodeId=fd1a184030608, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Wed Jul 19 04:23:00 CST 2017, time=2017-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725259, encodeId=1c0d1e252596e, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Thu Jun 08 21:23:00 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342391, encodeId=2c05134239102, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Sun May 28 07:23:00 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471534, encodeId=d94014e153475, content=<a href='/topic/show?id=c0132410554' target=_blank style='color:#2F92EE;'>#互作#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24105, encryptionId=c0132410554, topicName=互作)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dc87121468, createdName=ylz8405, createdTime=Sun May 28 07:23:00 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203027, encodeId=562f20302e01, content=学习了,文章很好谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat May 27 05:38:15 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202894, encodeId=629f20289448, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=08bb2061153, createdName=189****7206, createdTime=Fri May 26 21:06:32 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202848, encodeId=f537202848d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Fri May 26 16:37:25 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-27 1e0f8808m18(暂无匿称)

    学习了,文章很好谢分享。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1840306, encodeId=fd1a184030608, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Wed Jul 19 04:23:00 CST 2017, time=2017-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725259, encodeId=1c0d1e252596e, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Thu Jun 08 21:23:00 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342391, encodeId=2c05134239102, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Sun May 28 07:23:00 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471534, encodeId=d94014e153475, content=<a href='/topic/show?id=c0132410554' target=_blank style='color:#2F92EE;'>#互作#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24105, encryptionId=c0132410554, topicName=互作)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dc87121468, createdName=ylz8405, createdTime=Sun May 28 07:23:00 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203027, encodeId=562f20302e01, content=学习了,文章很好谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat May 27 05:38:15 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202894, encodeId=629f20289448, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=08bb2061153, createdName=189****7206, createdTime=Fri May 26 21:06:32 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202848, encodeId=f537202848d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Fri May 26 16:37:25 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 189****7206

    学习了谢谢分享。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1840306, encodeId=fd1a184030608, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Wed Jul 19 04:23:00 CST 2017, time=2017-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725259, encodeId=1c0d1e252596e, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Thu Jun 08 21:23:00 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342391, encodeId=2c05134239102, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Sun May 28 07:23:00 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471534, encodeId=d94014e153475, content=<a href='/topic/show?id=c0132410554' target=_blank style='color:#2F92EE;'>#互作#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24105, encryptionId=c0132410554, topicName=互作)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dc87121468, createdName=ylz8405, createdTime=Sun May 28 07:23:00 CST 2017, time=2017-05-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203027, encodeId=562f20302e01, content=学习了,文章很好谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat May 27 05:38:15 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202894, encodeId=629f20289448, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=08bb2061153, createdName=189****7206, createdTime=Fri May 26 21:06:32 CST 2017, time=2017-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202848, encodeId=f537202848d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM6P57Bs8gOPaY1cQP9lIia0lmZOEXraGaoicqNToIslXDKw/0, createdBy=7a041951742, createdName=衣带渐宽, createdTime=Fri May 26 16:37:25 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 衣带渐宽

    学习

    0

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