Objective To analyze the relationship between blood pressure level and the causes of cerebral infarc-tion in TOAST classification,degree of neurological impairment,prognosis in patients with acute ischemic stroke.Methods A total of 106 patients with acute ischemic stroke who were admitted to the Department of Neurology,Sinopharm Tong-mei General Hospital from January 2021 to January 2023 were selected.According to the classification criteria for hyperten-sion,the patients were divided into group A(normal hypertension,BP＜140/90 mmHg,25 cases),group B(mild to moderate hypertension,BP of 140-180/91-110 mmHg,67 cases)and group C(severe hypertension,BP ≥ 180/111 mmHg,14 cases).TOAST type of each group was determined at admission.The National Institutes of Health Stroke Scale(NIHSS)score was used to evaluate the degree of neurological impairment and the modified Barthel index(MBI)was used to evaluate the prog-nosis.The relationship between blood pressure level and above indicators was analyzed.Results Among the 106 patients,there were 52 patients with large artery atherosclerosis(LAA)-type stroke,24 patients with cardiogenic embolism(CE)-type stroke and 30 patients with small artery occlusion(SAO)-type stroke.Systolic blood pressure of CE group was lower than that of LAA group and SAO group at admission(P＜0.05).The NIHSS scores of group C at admission were significantly higher than those of group B and group A(P=0.005,＜0.001).During 3 months of follow-up after treatment,MBI scores of group B were significantly higher than those of group A and group C(P＜0.05).According to the MBI score,the patients were divided into good prognosis subgroup(74 patients with MBI score＞60)and poor prognosis subgroup(32 patients with MBI score＜60).There was statistically significant difference in NIHSS score at admission and decreases in systolic and diastolic blood pressure in 24h after admission between the 2 groups(P＜0.05).Multivariate Logistic regression analysis found that the NIHSS score high at admission,decreases in systolic blood pressure and diastolic blood pressure in 24h after admission were prognostic factors of acute ischemic stroke[OR(95％CI)=2.428(1.053-5.595),3251(1.166-9.062),3.483(1.109-10.942),P＜0.05].Conclusion Patients with CE-type acute ischemic stroke have lower systolic blood pressure than those with LAA-type and CE-type acute ischemic stroke at admission.Besides,patients with different blood pressure levels have different NIHSS scores and MBI scores.The NIHSS score at admission and decrease in blood pressure in 24h after admission are prognostic factors.
维普
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