【摘要】 目的 :分析血压变异性与急性后循环梗死患者预后的相关性,为临床工作中急性后循环梗死患者的预后评估提供参考依据。方法 :以160例急性后循环梗死患者为研究对象,开展前瞻性对照分析。患者治疗及后续康复训练指导由我院完成,研究终点为发病后3个月,根据改良Rakin评分(mRS),将mRS评分0～2分者纳入预后良好组,将mRS评分3～6分者纳入预后不良组。比较两组患者入院时动态血压、血压变异性差异,并运用受试者工作特征曲线(ROC),分析血压变异性预测患者预后不良的价值。结果 :1例失访,159例患者中共有57例预后不良,其余102例预后良好。预后良好组与预后不良组各项动态血压指标比较,差异无统计学意义(P> 0.05)。预后良好组24 h SSD、24 h DSD及nSSD低于预后不良组,差异有统计学意义(P <0.05)。以24 h SSD≥9.96%为截断值,其预测急性后循环梗死患者预后不良的AUC为0.796;nSSD≥10.03%为截断值,其AUC为0.713;24 h DSD≥11.08%为截断值,AUC为0.655。结论 :急性后循环梗死患者24 h SSD、24 h DSD及nSSD升高提示预后不良,监测患者血压变异性能够为预后质量的评估及诊疗对策的调整提供可靠参考。更多还原

【Abstract】 Objective: A prospective study was to analyze the correlation between blood pressure variability and the prognosis of patients with acute posterior circulation infarction, and to provide a reference basis for the prognosis evaluation of patients with acute posterior circulation infarction in clinical work. Methods: One hundred sixty cases of acute posterior circulation infarction were studied. Patients’ treatment and follow-up rehabilitation training guidance were completed by our hospital. The end point of the study was 3 months after the onset of the disease. According to the improved modified Rankin Scale(mRS), patients with mRS score of 0-2 were included in the good prognosis group, and those with mRS score of 3-6 were included in the bad prognosis group. Dynamic blood pressure and blood pressure variability at admission were compared between the two groups, and the value of predicting poor prognosis of patients with blood pressure variability was analyzed using the subjects’ work characteristic curve(ROC). Results: 1 case was lost to follow-up, with a total of 57 cases having poor prognosis and the remaining 102 cases having good prognosis. There was no significant difference in the dynamic blood pressure indexes between the group with good prognosis and the group with poor prognosis(P>0.05). In the group with good prognosis, 24 h SSD, 24 h DSD and nSSD were lower than those in the group with poor prognosis, and the difference was statistically significant(P<0.05). The AUC predicting poor prognosis in patients with acute posterior circulation infarction was 0.796, with SSD greater than 9.96% at 24 h as the truncated value. NSSD greater than or equal to 10.03% is truncated value, and its AUC is 0.713. At 24 h, DSD greater than or equal to 11.08% was truncated, and AUC was 0.655. Conclusions: The elevation of SSD, DSD and nSSD at 24 h and 24 h in patients with acute posterior circulation infarction suggest poor prognosis. Monitoring patients’ blood pressure variability can provide reliable reference for the assessment of prognosis quality and the adjustment of diagnosis and treatment strategies.更多还原