Prediction of early neurological deterioration in patients with middle cerebral atherosclerosis infarction by blood pressure variability combined with blood pressure stratification
Objective To investigate the relationship between blood pressure variability and early neurological deterioration(END)24 hours after admission in patients with acute middle cerebral atherosclerosis infarction.Methods A total of 115 patients with large atherosclerotic cerebral infarction in the middle cerebral artery admitted to the General Hospital of Hebei Province from June 2022 to June 2023 were included.The blood pressure values of 24h after admission were monitored to calculate the variability parameters of systolic blood pressure,mean blood pressure and diastolic blood pressure.The outcome of neurological deterioration was determined by the change of NIHSS score.A total of 23 patients experienced deterioration.The general data and parameters of blood pressure variability in the worsening group and the non-worsening group were analyzed,and the difference factors were obtained,and a regression model was established to analyze the relationship between them and END.The blood pressure of hospitalized patients was stratified according to the mean blood pressure,and the relationship between blood pressure variability and END in different blood pressure levels was analyzed.Results Of the 115 patients included in the study,23(20％)developed END.Compared with the non-worsening group,the low density lipoprotein[(3.41±1.16)mmol/L vs.(2.92±0.99)mmol/L],coefficient of variation in systolic blood pressure[(6.21±2.79)vs.(4.91±1.93)],NIHSS score[5(4,8)vs.3(2,5)],and history of hypertension(91.3％vs.64.1％)in the worsening group were significantly increased(t=2.033、2.094,Z=3.634,x2=6.417,P＜0.05).Regression analysis showed that the coefficient of systolic blood pressure variation(OR=1.253,95％CI=1.002～1.568,P=0.048)was a predictor of END.In the systolic blood pressure＜140 mmHg group,the proportion of hypertension variability in the worsening group(71.42％)was significantly higher than that in the non-worsening group(28.57％)(P＜0.05),and there was no significant difference in residual blood pressure stratification(P＞0.05).Conclusion Coefficient of systolic blood pressure variation is a risk factor for END of cerebral infarction.When the blood pressure level is low,the increase of blood pressure fluctuation is more likely to cause the occurrence of END.
Early neurological deteriorationBlood pressure stratificationAtherosclerosisCerebral infarction
万方数据
维普
