摘要
目的探讨脑梗死急性期降压治疗对患者3个月预后的影响。方法将346例发病48h内首发急性脑梗死患者随机分为干预组173例和对照组173例。干预组给予降压治疗，使其住院后第1天收缩压下降10％～20％，但不低于120／80mmHg（1mmHg=0．133kPa），第7天时血压降至140／90mm Hg以下，14d内血压维持在上述水平；对照组原则上不降压。2组患者均完成3个月随访，采用改良Rankin量袁评价2组患者发病后3个月死亡或残疾发生情况；多因素logistic回归分析降压治疗与预后的关系。结果与对照组比较，干预组患者3个月死亡或致残率明显降低（P〈0．01）。多因素logistic回归分析显示，急性期降压治疗可降低脑梗死患者发病后3个月死亡或致残风险（RR=0．25，95％CI：0．14～0．43，P〈0．01）。结论脑梗死急性期降压治疗可能改善患者3个月的预后。
Objective To study the effect of antihypertensive treatment on 3 month prognosis in acute cerebral infarction （ACI） patients. Methods Three hundred and forty-six ACI patients were randomly divided into antihypertensive treatment group （n=173） and control group （n=173）. Pa- tients in antihypertensive treatment group received antihypertensive treatment to reduce their sys- tolic blood pressure by 10%-20% but not ≥120/80 mm Hg within 1 day after admission,to de crease their blood pressure to below 140/90 mm Hg on day 7 after admission,and maintained it at 140/90 mm Hg within 14 days after admission. No measure was taken to reduce the blood pres- sure in control group. The patients were followed up for 3 months. The 3-month mortality and disability rate were assessed according to the modified Rankin scale. Relation between antihyper- tensive treatment and prognosis in ACI patients was analyzed by multivariate logistic regression analysis. Results The 3-month mortality and disability rate were significantly lower in antihyper tensive treatment group than in control group （P〉0.01）. Multivariate logistic regression analysis showed that antihypertensive treatment could reduce the 3-month mortality and disability rate in ACI patients （RR=0. 25,95% CI.0. 14-0. 43,P〈0.01）. Conclusion Antihypertensive treat- ment can improve the 3-month prognosis of ACI patients.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2013年第10期1018-1020,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
脑梗死
抗高血压药
血管紧张素转换酶抑制药
干预性研究
brain infarction
antihypertensive agents
angiotensin-converting enzyme inhibitors
in tervention studies
