Prognostic impact of blood pressure changes after intravenous thromboly-sis in patients with acute ischemic stroke
Objective To find the influence of blood pressure changes within 24 h after intraveneous thrombolytic on the prognosis of patients with acute ischemic stroke(AIS).Methods A total of 183 AIS intraveneous thrombilysis patients treated in Beijing Changping District Hospital from July 2021 to March 2023 were retrospectively collected.The functional recovery of the patients at 90 days was assessed using the modified Rainkin scale(mRS)score.Scores 0-2 were included in the good function group,and 3-6 scores were included in the poor function group.The factors affecting the prognosis of patients were analyzed by univariate analysis,and the adverse factors affecting the prognosis of patients with blood pressure variability(BPV)were analyzed by multivariate analysis.The predictive efficacy of BPV on the prognosis of patients with AIS intravenous thrombolysis was analyzed by receiver operating characteristics(ROC)curve.Results There were statistically significant differences between the two groups in age,history of diabetes meuitus,red blood cells,hemoglobin,triglycerides,homocysteine,pre-thrombolysis National Institute of Health stroke scale(NIHSS)scores,mean systolic/diastolic blood pressure,standard deviation of systolic/diastolic blood pressure,continuous systolic blood pressure variability,and mean true systolic blood pressure variability(P＜0.05).Logistic regression analysis showed:age(OR=1.039,95%CI:1.002-1.077),mean systolic blood pressure(OR=1.039,95%CI:1.008-1.071),continuous systolic blood pressurevariability(OR=1.111,95%CI:1.019-1.212),and pre-thrombolytic NIHSS score(OR=1.269,95%CI:1.133-1.421)were independent risk factors for the prognosis of AIS patients(P＜0.05);ROC curve analysis showed that mean systolic blood pressure(AUC[95%CI]=0.724[0.642-0.806],P＜0.001)and continuous systolic blood pressure variability(AUC[95%CI]=0.643[0.549-0.738],P＜0.005)had predictive effect on prognosis of AIS patients.Conclusion Patients with AIS are prone to poor prognosis due to high BPV within 24 hours after intravenous thrombolysis.BPV improves the efficacy of assessing the prognosis of patients undergoing intravenous thrombolysis in AIS.
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