【摘要】 目的：研究血压变异性与急性脑梗死早期神经功能恶化（END）的相关性，并探讨其对早期神经功能恶化的预测价值。方法：选取急性脑梗死患者59例，根据入院72 h内国立卫生研究院卒中量表（NIHSS）评分将其分为发生END组（n=31）和未发生END组（n=28），所有受试对象接受24 h动态血压监测，记录血压的平均值和变异系数。比较两组患者的一般资料和血压变异性指标，并进行相关性分析；采用ROC曲线分析血压变异性指标对急性脑梗死END的预测价值。结果：发生END组患者入院NIHSS评分平均为（7.35±3.42）分，未发生END组患者入院NIHSS评分平均为（5.07±2.76）分，发生END组患者入院NIHSS评分显著高于未发生END组患者，差异有统计学意义（P<0.05）。患者入院时NIHSS评分与24 h收缩压变异系数、24 h舒张压变异系数均呈正相关（r值分别为0.325和0.403,P<0.05）。ROC分析显示，24 h收缩压变异系数和24 h舒张压变异系数预测急性脑梗死END的ROC曲线下面积AUC分别为0.706和0.634。结论：血压变异性与急性脑梗死早期神经功能恶化密切相关，24 h收缩压变异系数可准确预测END的发生。更多还原

【Abstract】 OBJECTIVETo analyze the relationship and predictive value of blood pressure variability on early neurological deterioration(END) in patients with acute ischemic stroke. METHODS 59 patients with acute ischemic stroke were selected and divided into the END group and non-END group based on the NIHSS score within 72 hours of admission. All subjects underwent 24-hour ambulatory blood pressure monitoring to record the mean value and coefficient of variation of blood pressure. General information and blood pressure variability indicators of the two groups were compared, and correlation analysis was performed. ROC curve analysis was used to evaluate the predictive value of blood pressure variability indicators for END in acute ischemic stroke. RESULTS The average NIHSS score of patients admitted to hospital in the END group was(7.35±3.42) points, and the average NIHSS score of patients admitted to hospital in the END group was(5.07±2.76) points, and the average NIHSS score of patients admitted to hospital in the END group was significantly higher than that of patients admitted to hospital in the end group, with statistical significance(P<0.05). The NIHSS score at admission was positively correlated with the coefficient of variation of 24-hour systolic blood pressure and24-hour diastolic blood pressure(r=0.325, 0.403, P<0.05). ROC analysis showed that the area AUC under ROC curve of the END of acute cerebral infarction predicted by the coefficient of variation of 24-hour systolic blood pressure and 24-hour diastolic blood pressure was 0.706 and 0.634, respectively. CONCLUSION Blood pressure variability is closely related to early neurological deterioration in acute ischemic stroke, and the coefficient of variation of systolic blood pressure at 24 hours can accurately predict the occurrence of END.更多还原