血压变异性与脑死溶栓治疗后出血转化的相关性研究.docVIP

血压变异性与脑梗死溶栓治疗后出血转化的相关性研究 张泽进 (深圳市龙华新区观澜人民医院内二科，广东深圳518110) 【摘要】 目的 探讨临床中脑梗死溶栓治疗后出血转化的发生与血压变异性之间的相关性。方法 对2008年6月至2012年6月在本院进行溶栓治疗治疗的急性脑梗死溶栓治疗的84名患者，行CT或MRI检查，并监测治疗后的24 h动态血压。结果 脑梗死患者溶栓治疗后HT在本研究组中的发生率为率17.9%。HT组24h SBP及DBP（146.4±17.0，94.6±15.4）显著性高于无HT组（132.7±11.3，88.4±9.0）（均P0.05）；24h SBP及DBP的CV（11.6±3.7，16.3±5.6）与无HT组（8.5±2.6，10.2±3.1）间存在显著性差异（均P0.01）。结论 本研究结果表明脑梗死溶栓治疗后出血转化与血压变异性相关。 【关键词】：脑梗死；出血转化；血压变异性；溶栓治疗 Relationship between hemorrhagic transformation after cerebral infarction thrombolytic therapy and blood pressure variability ZHANGZE-Jin (TheShenzhen city Longhua District Peoples Hospital Branch of the two hills,ShenZhen518110China) 【Abstract】Objective To explore the association between hemorrhagic transformation after cerebral infarction thrombolytic therapy and blood pressure variability in clinical. Methods 84 patients with cerebral infarction admitted to our hospital from June 2008 to June 2012 were included, and all patients were performed CT/MRI and 24h ambulatory blood pressure monitoring after thrombolytic therapy. Results Hemorrhagic transformation occurred in 15 (17.9%) of the 84 patients with cerebral infarction after thrombolytic therapy. 24h SBP and DBP of HT group (146.4±17.0, 94.6±15.4) were significantly higher than the non-HT group (132.7±11.3, 88.4±9.0) (all P0.05), and significant differences of blood pressure variability also existed between HT group (11.6±3.7, 16.3±5.6) and non-HT group (8.5±2.6, 10.2±3.1) (all P0.01). Conclusion This study indicates that hemorrhagic transformation in patients with cerebral infarction after thrombolytic therapy is associated with blood pressure variability. 【Key words】：Cerebral infarction；Hemorrhagic transformation；Blood pressure variability；Thrombolytic therapy 前言 脑梗死（cerebral infarction，CI）是心脑血管疾病中常见的并发症，具有高致残率及死亡率。尽管降低高血压患者的血压能够有效减少脑卒中事件的发生[1,2]，但近来的研究表明，收缩压的变异性是独立于平均收缩压之外更强的脑卒中预测因子[3,4]。 血压变异性（blood pressure variability，BPV）是描述一定时间内血压波动的程度，通常用动态血压标准差（standard deviation，SD）与变异