摘要
目的监测不同时间急性脑梗死伴高血压患者的血压水平,探索血压变化规律,并探讨急性期降压治疗的优势。方法回顾性收集2023年1月至2024年6月福建医科大学附属闽东医院收治的80例急性脑梗死伴高血压患者资料,根据急性期是否进行降压治疗分为研究组(40例,采取降压治疗)和对照组(40例,未采取降压治疗)。比较两组研究患者基础资料,纳入有差异的因素进行Logistic回归分析,探索认知功能障碍的相关因素。结果所有患者入院时MAP、SBP、DBP水平均高于正常值,入院时有57例(71.25%)收缩压(SBP)≥140mmHg,34例(42.50%)舒张压(DBP)≥90 mmHg。相比入院时,入院后第1d的SBP、平均动脉压(MAP)水平均显著下降(P<0.05);入院后第7d的SBP、DBP水平均显著下降(P<0.05)。MAP、SBP、DBP水平于入院8h内明显下降,在入院48h后趋于稳定状态。多因素Logistic回归分析发现年龄≥65岁、MAP≥52 mmHg、高尿酸血症(HUA)、高同型半胱氨酸血症(HHcy)、C反应蛋白(CRP)>10 mg/L为认知功能障碍的独立危险因素,教育水平为高中及以上和降压治疗为认知功能障碍的独立保护因素。结论急性脑梗死伴高血压患者,积极控制患者血压水平可改善患者预后,降低认知功能障碍的发生。年龄≥65岁、MAP≥52 mmHg、HUA、HHcy、CRP>10 mg/L为认知功能障碍的独立危险因素,教育水平为高中及以上和降压治疗为认知功能障碍的独立保护因素。
Objective To monitor the blood pressure levels of patients with acute cerebral infarction and hypertension at different times,explore the patterns of blood pressure changes,and investigate the advantages of antihypertensive treatment during the acute phase.Methods A retrospective collection of data was conducted on 80 patients with acute cerebral infarction and hypertension admitted to Fujian Medical University Affiliated Mindong Hospital from January 2023 to June 2024.The patients were divided into a study group(40 cases,treated with antihypertensive therapy)and a control group(40 cases,not treated with antihypertensive therapy)based on whether antihypertensive therapy was performed during the acute phase.Compare the basic data of two groups of study patients,include factors with differences for logistic regression analysis,and explore the related factors of cognitive dysfunction.Results All patients had MAP,SBP,and DBP levels higher than normal upon admission.Among them,57 cases(71.25%)had systolic blood pressure(SBP)≥140mmHg and 34 cases(42.50%)had diastolic blood pressure(DBP)≥90 mmHg upon admission.Compared with admission,the levels of SBP and mean arterial pressure(MAP)significantly decreased on the first day after admission(P<0.05);On the 7th day after admission,the levels of SBP and DBP significantly decreased(P<0.05).The levels of MAP,SBP,and DBP significantly decreased within 8 hours of admission and stabilized 48 hours after admission.Multivariate logistic regression analysis found that age≥65 years,MAP≥52 mmHg,hyperuricemia(HUA),hyperhomocysteinemia(HHcy),and C-reactive protein(CRP)>10 mg/L were independent risk factors for cognitive dysfunction,while education level of high school or above and antihypertensive treatment were independent protective factors for cognitive dysfunction.Conclusion In patients with acute cerebral infarction and hypertension,actively controlling their blood pressure levels can improve their prognosis and reduce the occurrence of cognitive dysfunction.Age≥65 years,MAP≥52 mmHg,HUA,HHcy,CRP>10 mg/L are independent risk factors for cognitive impairment,while education level of high school or above and antihypertensive treatment are independent protective factors for cognitive impairment.
作者
舒海林
SHU Hailin(Department of Critical Care Medicine,Mindong HospitalAffiliated to Fujian Medical University,Fuan 355000,China)
出处
《中华灾害救援医学》
2024年第12期1427-1431,共5页
Chinese Journal of Disaster Medicine
关键词
脑梗死
高血压
认证障碍
brain infarction
hypertension
cognition disorders
