论文部分内容阅读
目的 :探讨缺血性卒中静脉溶栓后24小时内血压波动对出血转化的影响。方法 :收集2010年9月~2015年9月我院收治的采用静脉rt PA溶栓治疗的急性缺血性卒中患者,测量静脉溶栓前血压,开始溶栓治疗后使用心电监护仪测量24h内的血压,溶栓24h内复查CT或MRI评估出血转化。结果 :HI型出血患者的基线SBP、SBPmean、SBPmax均较无出血患者低;PH型出血患者的SBPsd、SBPsv、SBPsvmaxrise、基线DBP、DBPmean均较无出血患者高,差异均有统计学意义;HI型出血患者溶栓后SBPmean0-6、SBPmean6-12均较无出血患者低;PH型出血患者溶栓后SBPsv0-6、DBPmean0-6、DBPmean6-12均较无出血患者高,差异均有统计学意义。结论 :静脉溶栓后24小时内收缩压变异度是急性缺血性卒中患者发生PH型出血的独立危险因素;仅静脉溶栓后0~12小时内的血压波动水平与出血转化存在相关性。
Objective: To investigate the influence of blood pressure fluctuation on the transformation of hemorrhage within 24 hours after intravenous thrombolysis in ischemic stroke. Methods: Acute ischemic stroke patients treated with intravenous rtPA thrombolysis in our hospital from September 2010 to September 2015 were collected. Blood pressure before intravenous thrombolysis was measured. After initial thrombolysis, ECG was used to measure 24h Within the blood pressure, thrombolysis 24h review CT or MRI to assess the conversion of hemorrhage. Results: The baseline SBP, SBPmean and SBPmax of HI patients were lower than those without bleeding. The SBPsd, SBPsv, SBPsvmaxrise, DBP and DBPmean of patients with PH type hemorrhage were higher than those without hemorrhage, and the differences were statistically significant. HI SBPmean0-6 and SBPmean6-12 after thrombolysis were lower than those without bleeding in patients with hemorrhage; SBPsv0-6, DBPmean0-6 and DBPmean6-12 after thrombolysis in PH-type hemorrhage patients were higher than those without hemorrhage, the differences were statistically significant significance. CONCLUSIONS: The systolic blood pressure variability within 24 hours after intravenous thrombolysis is an independent risk factor for PH-type hemorrhage in patients with acute ischemic stroke. Only the fluctuation of blood pressure within 0-12 hours after intravenous thrombolysis is associated with hemorrhagic transformation.