大半球心脏病发作后血压和恶性脑 edem 之间的时间变化的关联:一个前性队列研究
Xindi Song1,2,3, Yanan Wang1,2,3, Wen Guo1,4
1Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
概括
在大半球心脏病发作 (LHI) 后,血压 (BP) 管理至关重要. 在前12个小时内,在13-24小时之间增加的静脉血压 (SBP) 和在前12小时内超过70mmHg的静脉血压 (DBP) 会增加恶性脑 (MBE) 的风险.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
背景情况:
- 大型半球心脏病发作 (LHI) 构成发展恶性脑 edem (MBE) 的重大风险.
- 血压 (BP) 波动在LHI患者中很常见,可能会影响结果.
- 了解BP和MBE之间的动态关系对于及时干预至关重要.
研究的目的:
- 调查大半球心脏病发作 (LHI) 患者的血压 (BP) 和恶性脑 edem (MBE) 风险之间的时间变化的关联.
- 确定与LHI后MBE风险增加相关的特定BP门和时间窗口.
主要方法:
- 预期在发病后48小时内招收LHI患者.
- 在24小时内每小时监测血压,分为12小时时段 (1-12h和13-24h) 进行分析.
- 用于评估BP-MBE关联的概括估计方程,后勤回归和受限制的立方线.
主要成果:
- 在24小时平均缩血压 (SBP) 和MBE风险 (P=0.029) 之间观察到U形的关联.
- 在发病后13-24小时内,较高的SBP与增加的MBE风险相关 (aOR 1.02).
- 在1-12小时内透析血压 (DBP) 超过70mmHg (aOR1.03) 和在13-24小时内>75mmHg与更高的MBE风险有关.
结论:
- 在LHI患者中,24小时平均SBP显示了与MBE风险的U形关联,在后期 (13-24小时) 有显著的正相关性.
- DBP表现出值效应,特别是在早期阶段 (1-12小时) 的升高水平会增加MBE风险.
- 这些发现强调了动态血压监测和管理LHI患者减轻MBE发展的重要性.
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