国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Different contribution of SBP and DBP variability to vascular events in patients with stroke

第一作者：Liye Dai,Aichun Cheng

通讯作者：Yongjun Wang

caridiovascular events blood pressure variability

基本信息

2020-03-05

已发表文章

发表杂志：stroke and vascular neurology

发表类型: Article

影响因子(IF): 4.081

PMID: svn-2019-000278 Pubmed原文链接 全文下载

主要研究背景及目的

脑血流供应依赖于收缩压（Systolic blood pressure，SBP）水平，而心脏血流供应则依赖于舒张压（diastolic blood pressure，DBP）水平，据此我们推测：收缩压变异性（systolic blood pressure variability， SBPV）可能和卒中具有密切相关性，而舒张压变异性（diastolic blood pressure variability， DBPV）可能仅对心血管事件产生影响。

方法

本研究所有数据来源于“血压与卒中临床结局的队列研究”（Blood Pressure and Clinical Outcome in Stroke Survivors, BOSS），BOSS研究为多中心（全国61家医院）、前瞻性、观察性研究，入组病例均为发病7天内的缺血性卒中和TIA患者，均使用统一发放的电子血压计(HEM-4030, OMRON Life Science Co. Ltd, Kyoto, Japan) 行每日2次血压监测，从入院后第1天连续监测至卒中后90天。血压变异性利用标准差和变异系数计算。临床结局定义为卒中后90天的非致死性卒中复发（脑梗死、脑出血）和心血管事件（心肌梗死、心绞痛、冠状动脉支架植入术、心力衰竭、心血管死亡）。采用COX回归模型检测血压变异性与卒中复发的相关性，以logistic回归模型进行血压变异性与心血管事件的相关性分析。

结论

For patients with IS/TIA, stroke recurrence was associated with both SBPV and DBPV; however, cardiovascular events seem to be only related to DBPV.

主要结果

Of 2325 patients with IS or TIA, 103 (4.43 %) experienced a recurrent stroke and 64 (2.75 %) had cardiovascular events within 3 months. Day-to- day SBPV was only associated with stroke recurrence (BPVSD: OR, 1.72, 95% CI 1.09 to 2.71; BPVCV: 1.86, 95% CI 1.19 to 2.92), but not cardiovascular events (BPVSD: 1.67, 95% CI 0.94 to 2.94; BPVCV: 1.51, 95% CI 0.86 to 2.64). However, DBPV seems to be related to both stroke (BPVSD: 1.60, 95% CI 1.02 to 2.49; BPVCV: 1.53, 95% CI 0.99 to 2.37) and cardiovascular events (BPVSD: 2.48, 95% CI 1.37 to 4.48; BPVCV: 1.92, 95% CI 1.09 to 3.36). Similar results were found at 1 year.