| Objective To investigate the relationship between blood pressure variability 24 hours after admission and neurological deterioration within 3 days in patients with acute cerebral infarction.Methods A total of 187 patients with acute cerebral infarction were enrolled in the Department of Neurology,Affiliated Hospital of North China University of Science and Technology from 2020 to 2022.Blood pressure values of the patients were monitored 24 hours after admission and measured at intervals of 3 hours.Blood pressure variability parameters of the patients were calculated using 8 blood pressure measurements.neurological deterioration was determined by NIHSS score.Patients were scored at least twice a day within 3 days before admission,and clinical data and test results of patients were collected.Independent sample T test was used for measurement data and Chi-square test was used for counting data.General baseline data and blood pressure variability parameters were analyzed,and the relationship between blood pressure variability parameters and neurological deterioration in the early stage of acute cerebral infarction was analyzed by binary logistic regression model.The blood pressure of hospitalized patients was stratified by the mean of 24 hours’ systolic blood pressure,which was divided into four groups: systolic blood pressure<140mm Hg,140 mm Hg≤systolic blood pressure<160mm Hg,160 mm Hg≤systolic blood pressure<180mm Hg,and systolic blood pressure≥180mm Hg.The relationship between blood pressure variability and early neurological deterioration under different blood pressure levels was analyzed.The blood pressure variability was divided into quartile groups and the early deterioration of neurological function was observed as the blood pressure variability changed from low to high.Finally,ROC curve was drawn to analyze the ability of blood pressure variability to predict early neurological deterioration in patients with acute cerebral infarction.Results 1 Of the 187 patients enrolled,39 had early neurological deterioration.Systolic blood pressure standard deviation,systolic blood pressure coefficient of variation,diabetes mellitus and NIHSS scores were significantly higher in patients with worsening than the non-worsening group,the differences were statistically significant.Regression analysis showed diabetes(OR=2.810,95%Cl: 1.216-6.490,P=0.016),Systolic blood pressure coefficient of variation(OR=2.303,95%Cl: 1.107-4.792,P=0.026)and NIHSS score(OR=1.407,95%Cl: 1.201-1.647,P<0.001)was an independent predictor of early neurological deterioration.2 In the systolic blood pressure<140mm Hg group,the proportion of hypertension variability in the worsening group(73.33%)was higher than that in the the non-worsening group(38.24%),and the difference was statistically significant(P<0.05),while no significant difference was found in the residual blood pressure group.3 The coefficient of variation of systolic blood pressure was divided into four groups according to the quartile.With the quartile increasing from low to high,the proportion of early neurological deterioration tended to increase.4 ROC curve plotting the relationship between early neurological deterioration and systolic blood pressure variation coefficient in patients with cerebral infarction showed that the area under the curve was 0.675(P<0.05),the diagnostic threshold of coefficient of variation of systolic blood pressure was 5.064,the sensitivity was 0.692,the specificity was 0.655.Conclusions The coefficient of variation of 24 h systolic blood pressure is a predictor of neurological deterioration in the early stage of acute cerebral infarction and has certain predictive value.When blood pressure level is low,increased blood pressure fluctuation may be more likely to cause early neurological deterioration in patients with cerebral infarction.in the early stage of acute cerebral infarction,it is of guiding significance to avoid hypotension and keep blood pressure stable.Figure 2;Table 10;Reference 138... |
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