中国卒中杂志2025，Vol.20Issue(10)：1261-1269,9.DOI:10.3969/j.issn.1673-5765.2025.10.008
急性缺血性卒中患者再灌注治疗后血压变异性与功能预后的相关性研究
Correlation between Blood Pressure Variability and Functional Outcomes in Patients with Acute Ischemic Stroke after Reperfusion Therapy
摘要
Abstract
Objective To evaluate the correlation between blood pressure variability(BPV)across all phases(acute phase,subacute phase,and home blood pressure monitoring phase)and functional outcomes in acute ischemic stroke(AIS)patients after reperfusion therapy. Methods AIS patients who underwent reperfusion therapy(intravenous thrombolysis and/or endovascular treatment)at the Department of Neurology,Beijing Daxing District People's Hospital were prospectively and consecutively enrolled from July 2022 to October 2023.Demographic information,medical history,pre-onset mRS scores,admission NIHSS scores,onset-to-treatment time,and in-hospital treatment details were collected.Blood pressure was monitored from admission to 3 months after reperfusion therapy,and BPV indicators for each phase were calculated.Based on the 3-month mRS scores,patients were divided into a good functional outcome group(mRS score 0-2)and a poor functional outcome group(mRS score 3-6).Baseline characteristics and BPV indicators were compared between the two groups.Multivariate logistic regression analysis was performed to evaluate the effects of BPV at each phase on the functional outcomes of AIS patients. Results A total of 218 patients were enrolled,including 156 males(71.6％),with a mean age of(63±12)years.There were 180 patients in the good functional outcome group and 38 patients in the poor functional outcome group.Compared with the good functional outcome group,the poor functional outcome group had a higher systolic blood pressure standard deviation in the acute phase[12.51(10.99-14.41)mmHg vs.9.92(8.40-11.59)mmHg,P＜0.001],a higher systolic blood pressure standard deviation in the subacute phase[12.52(10.67-13.92)mmHg vs.10.49(8.73-12.36)mmHg,P＜0.001],a higher systolic blood pressure standard deviation during the home blood pressure monitoring phase[9.02(8.11-12.61)mmHg vs.6.61(5.53-7.92)mmHg,P＜0.001],and a higher diastolic blood pressure standard deviation during the home blood pressure monitoring phase[6.16(4.67-7.66)mmHg vs.5.17(4.28-6.03)mmHg,P=0.005].After adjusting for confounding factors,multivariate logistic regression analysis showed that increased systolic blood pressure standard deviation at each phase was associated with poor functional outcomes at 3 months:systolic blood pressure standard deviation in the acute phase(adjusted OR 1.17,95％CI 1.04-1.31,P=0.008),systolic blood pressure standard deviation in the subacute phase(adjusted OR 1.29,95％CI 1.06-1.57,P=0.013),and systolic blood pressure standard deviation during the home blood pressure monitoring phase(adjusted OR 2.35,95％CI 1.54-3.59,P＜0.001).All differences were statistically significant.An increased diastolic blood pressure standard deviation during the home blood pressure monitoring phase was also associated with poor functional outcomes at 3 months(adjusted OR 1.85,95％CI 1.20-2.84,P=0.005).The results were consistent across multiple BPV indicators. Conclusions Increased systolic blood pressure variability during the acute,subacute,and home blood pressure monitoring phases may increase the risk of poor functional outcomes at 3 months in AIS patients after reperfusion therapy.关键词
急性缺血性卒中/再灌注治疗/血压变异性/功能预后/家庭血压监测Key words
Acute ischemic stroke/Reperfusion therapy/Blood pressure variability/Functional outcome/Home blood pressure monitoring分类
临床医学引用本文复制引用
尹梦鑫,段春苗,杨海华..急性缺血性卒中患者再灌注治疗后血压变异性与功能预后的相关性研究[J].中国卒中杂志,2025,20(10):1261-1269,9.基金项目
北京市大兴区人民医院科技项目(4202215428) （4202215428）
