Relationship between Neurological Deterioration and Blood Pressure/Heart Rate Variability in Patients with Acute Cerebral Infarction
Relationship between Neurological Deterioration and Blood Pressure/Heart Rate Variability in Patients with Acute Cerebral Infarction
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急性脑梗塞患者神经功能恶化与血压/心率变异的关系
DOI：
10.1016/j.jstrokecerebrovasdis.2022.106504
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发表时间：
2022
影响因子：
2.5
通讯作者：
Tomimoto Hidekazu
中科院分区：
文献类型：
--
作者：
Shimada Takaaki;Shindo Akihiro;Imai Hiroshi;Momosaki Ryo;Suzuki Hidenori;Tomimoto Hidekazu
目的住院期间神经功能恶化（ND）是卒中后不良预后的独立预测因子。中风后48小时内影响早期ND的危险因素已被深入研究，而转移到轮椅后的晚期ND的数据很少。因此，它被调查是否血液动力学因素可能会影响晚期ND在hospitalization.Materials和MethodsA回顾性研究进行了135例动脉粥样硬化血栓性或心源性脑梗死谁是2014年4月1日至2017年7月31日之间，我院收治。在住院期间，分别测定收缩压（sBP）、舒张压（DBP）和心率（HR）的平均值、最大值和最小值。ND（+）组，其中在转移到轮椅时的改良Barthel指数评分在轮椅转移和出院之间显示出5分或更多的下降，以及ND（-）组，但事实并非如此。两组之间的生命指数进行了比较，并进行ROC曲线analysis.ResultsThe ND（+）组包括32例，ND（-）103。两组之间在sBP min（p= 0.029）、dBPmin（p= 0.019）、HRave（p= 0.028）和HRmax（p< 0.01）四个项目上存在显著差异。ND（+）组sBPmin、dBPmin低于ND（-）组，HRave、HRmax高于ND（-）组。结论转移到轮椅上后的晚期ND与住院期间的生命指标有关，应谨慎管理，以预防晚期ND
ObjectivesNeurological deterioration (ND) during hospitalization is an independent predictor of poor prognosis after stroke. Risk factors affecting early ND within 48 h post stroke have been intensively investigated, while few data are available on those for late ND after transfer to a wheelchair. Therefore, it was investigated whether hemodynamic factors may affect the late ND during hospitalization.Materials and methodsA retrospective study was conducted on 135 patients with atherothrombotic or cardiogenic cerebral infarction who were admitted to our hospital between April 1st, 2014 and July 31st, 2017. During hospitalization, average, maximum, and minimum values were determined for systolic blood pressure (sBP), diastolic BP (dBP), and heart rate (HR), respectively.135 patients were classified into two groups; ND (+) group, in which modified Barthel index score at the time of transfer to a wheelchair showed five points or more decrease between wheelchair transfer and discharge, and ND (−) group, which did not. Vital indices were compared between the two groups and subjected to ROC-curve analysis.ResultsThe ND (+) group included 32 patients, and the ND (−) 103. Significant differences were found between the groups in four items; sBPmin (p= 0.029), dBPmin (p= 0.019), HRave (p= 0.028), and HRmax (p< 0.01). The ND (+) group showed lower sBPmin and dBPmin, and higher HRave and HRmax than the ND (−) group.ConclusionsLate ND after transfer to a wheelchair is related to the vital indices during hospitalization and should be cautiously managed to prevent late ND