Relationship between blood pressure variability and prognosis in acute ischemic stroke patients receiving intravenous thrombolysis
10.16781/j.0258-879x.2016.10.1201
- Author:
Yi JIANG
1
Author Information
1. Stroke Center, Changhai Hospital, Second Military Medical University
- Publication Type:Journal Article
- Keywords:
Blood pressure variability;
Brain infarction;
Thrombolytic therapy;
Tissue plasminogen activator
- From:
Academic Journal of Second Military Medical University
2016;37(10):1201-1205
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the relation between blood pressure fluctuation and prognosis of patients with acute ischemic stroke during intravenous thrombolysis, so as to guide the blood pressure management during super early stage of acute ischemic stroke and to improve the prognosis after intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA). Methods A total of 198 acute ischemic stroke patients, who received rt-PA intravenous thrombolysis during the time window between Sep. 2013 to Dec. 2015 in our stroke center, were included in this study, and the patients included 125 males and 73 females, aged (67. 6±12. 8) years old, ranging 22-91 years. NIHSS score was used to evaluate the function of the nervous system and modified Rankin Scale (mRS) score was used for evaluating the prognosis of patients. The blood pressure variation during the entire process of intravenous thrombolysis, which included the mean, maximum (max), minimum (min), range (max—min), standard deviation (SD), and successive variation(SV), were monitored. After baseline data correction, multiple logistic regression analysis was used to evaluate the influence of blood pressure on the long-term prognosis of patients. Results We found that the initial NIHSS score, time from onset to thrombolysis, average initial systolic blood pressure, and average initial pulse pressure, the maximum systolic/diastolic blood pressure during thrombolysis, SV of systolic/diastolic blood pressure during thrombolysis, and SV of the maximum systolic/diastolic blood pressure during thrombolysis, were the factors affecting the clinical outcomes of patients (P<0. 05, P<0. 01). The multiple logistic regression analysis showed that low initial NIHSS score, shorter time from onset to thrombolysis, low average initial systolic blood pressure, and low SV of systolic blood pressure and diastolic pressure were the independent predicting factors for good prognosis of acute ischemic stroke patients receiving rt-PA intravenous thrombolysis. Conclusion The prognosis of acute ischemic stroke is associated with the systolic blood pressure at beginning of thrombolysis, pulse pressure and pressure variability during thrombolysis. Great blood pressure fluctuation is associated with poor outcome of acute ischemic stroke, so efforts should be made to maintain stable blood pressure in the patients.
