| Objectives:This study was to observe the first visit blood pressure with acute cerebral infarction and the changes of blood pressure in 1 week after admission,and to compare the changes of blood pressure in different types of cerebral infarction.And to explore the clinical factors affecting the increase of blood pressure after cerebral infarction.It aims to provide a clinical evidence-based basis for scientific management of elevated blood pressure after cerebral infarction,and to guide the clinical treatment and prognosis.Methods:A total of 108 patients were enrolled in the emergency department of the emergency department of the Affiliated Hospital of Qingdao University Medical College from May20 to 2017,and the clinical data were collected.According to the TOAST classification of cerebral infarction,patients were divided into five groups,namely,large atherosclerotic type(LAA),cardiac embolization type(CE),small artery occlusion(SAO),unexplained type(SUE)and other etiological types(SDE).The main blood pressure measurement points were 0h,8h,16h,24h,48h,72h,4D,5D,6D and 7d.Patients with initial blood pressure exceeding 140/90mm Hg are referred to as elevated blood pressure.Observation index:(1)the characteristics of blood pressure changes of different types of cerebral infarction etiology,causes blood pressure were compared between the 5 types of cerebral infarction diagnosed patients with elevated blood pressure blood pressure,systolic blood pressure and diastolic blood pressure decreased in1 weeks,blood pressure decreased to a steady state time point,finally analyzes the various types of cerebral infarction blood pressure difference by repeated measurement of variance.(2)to investigate the related factors of cerebral infarction in patients with elevated blood pressure,respectively,Using chi square analysis and Logistic regression analysis of hypertension,high salt diet,age,gender,body mass index,TOAST type,sleep condition,the degree of neurological deficits,disturbance of consciousness,smoking and drinking,stroke,heart disease,diabetes and other factors.Results:(1)The first visit blood pressure in patients with systolic blood pressure average(166.5±20.6)mm Hg,LAA,CE,SAO,SUE and SDE in the blood pressure within 1weeks decreased respectively(13.4±4.4)mm Hg,(12.8±3.8)mm Hg,(14.2±4.2)mm Hg,(13.1±5.2)mm Hg,(12.71±5.3)mm Hg,5 causes type cerebral infarction in the mean systolic pressure and 1 weeks decrease without statistical difference(P>0.05).LAA,SAO,SUE,and SDE showed a steady decrease in blood pressure after 16h,while CE showed a steady decrease in 8h.the systolic blood pressure in cerebral infarction at different time points were statistically significant(F=42.5,P<0.01),but the cause of different types of cerebral infarction at different time SBP groups showed no statistical significance(F=2.06,P>0.05).(2)The first visit blood pressure in patients with diastolic blood pressure average(114.4±9.7)mm Hg,the blood pressure decreased 1weeks respectively(13.4±4.4)mm Hg、(12.8±3.8)mm Hg、(14.2±4.2)mm Hg、(13.1±5.2)mm Hg、(12.71±5.3)mm Hg,5 causes the type of cerebral infarction in 1 weeks and the mean diastolic pressure decrease without statistical difference(P>0.05).LAA,SAO,SUE,and SDE showed a steady decrease in blood pressure after 24h,and CE showed a steady decrease in blood pressure after 16h.At different time points were statistically significant in the diastolic pressure of cerebral infarction(F=48.6,P<0.01),but the cause of different types of cerebral infarction at different time points in diastolic blood pressure between two groups was not statistically significant(F=1.98,P>0.05).(3)Analysis of factors influencing the first visit blood pressure in elevated blood pressure by the chi square test,we can see the history of hypertension,high salt diet,age,sleep status,neurological deficit and disturbance of consciousness in the first patient blood pressure had significant difference between group and normal group(c~2=13.23,6.852,8.244,5.321,5.236,7.368,P respectively,<0.001,0.026,0.018,0.027,0.032,0.022).(4)Multivariate Logistic regression analysis of the factors affecting the statistical differences,results showed that history of hypertension,high salt diet and age factor for promoting the first diagnosis of high blood pressure cerebral infarction(OR=1.857,1.357,1.528),and sleep good,clear consciousness and nerve function defect lighter i s the protective factor first diagnosed with normal blood pressure(OR=0.756,0.851,0.784).Conclusion:The changes in systolic and diastolic blood pressure in the 5 types of cerebral infarction are approximately consistent,suggesting that the mechanis m of elevated blood pressure in patients with cerebral infarction may be the same.Through the study of factors affecting blood pressure elevated acute phase,found the first visit blood pressure is affected by blood pressure history,high salt diet,age,sleep status,neurological deficit and disturbance of consciousness and other factors,that is the result of increased blood pressure after cerebral infarction,a number of factors.Therefore,for patients with elevated blood pressure in acute period,this study advocates should pay close attention to the changes in blood pressure,take careful control of blood pressure measures for patients with hypertension undergoing extreme antihypertensive treatment,the purpose is to keep the blood pressure in a reasonable range,prevention of recurrence of cerebral infarction,reduce disability rate. |
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