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目的探讨缺血性卒中急性期不同降压方案对卒中后认知功能障碍(PSCI)的影响方法选取发病24 h内入院的首发缺血性脑卒中患者796例,按照高血压防治指南选取合理的降压方案并按其分组,对其认知功能进行1年的随访,采用logistics回归分析发病3个月时各降压方案与认知功能障碍之间的关系。结果以钙拮抗剂(CCB)+转换酶抑制剂(ACEI)+β-受体拮抗剂(βB)组为参照的logistics回归分析发现,单用药物组、四联降压组及其他组PSCI风险均显著高于参照组[CCB:OR=2.31,95%CI=1.22~4.39;ACEI:OR=3.07,95%CI=1.41~6.67;血管紧张素受体拮抗剂(ARB):OR=3.34,95%CI=1.40~7.96;CCB+ACEI+βB+D:OR=2.24,95%CI=1.04~5.67;CCB+ARB+βB+D:OR=2.50,95%CI=1.07~5.84;其他:OR=6.10,95%CI=1.72~21.61]。结论缺血性卒中急性期二联及三联降压方案对PSCI可能具有预防意义。
Objective To investigate the effect of different antihypertensive regimens on cognitive impairment (PSCI) after stroke in acute stage of ischemic stroke.Methods 796 first episode of ischemic stroke admitted within 24 hours of onset were selected according to the guideline of prevention and treatment of hypertension The hypotensive regimens were grouped and their cognitive function was followed up for 1 year. The logistic regression was used to analyze the relationship between each hypotensive regimen and cognitive impairment at 3 months of onset. Results Logistic regression analysis based on CCB + ACEI + βB group showed that PSI risk in single drug group, quadruple hypotensive group and other groups (CCB: OR = 2.31, 95% CI = 1.22-4.39; ACEI: OR = 3.07, 95% CI = 1.41-6.67; ARB: OR = 3.34, 95% CI = 1.40 ~ 7.96; CCB + ACEI + βB + D: OR = 2.24, 95% CI = 1.04-5.67; OR = 6.10, 95% CI = 1.72 ~ 21.61]. Conclusion The two-stage and three-stage antihypertensive regimens in the acute stage of ischemic stroke may be of preventive significance for PSCI.