The Relationship Between Short-term Blood Pressure Variability And Early Prognosis In Patients With Intracranial Hemorrhage

Objective: To explore the relationship between short-term blood pressure variabilityand early prognosis in patients with intracranial hemorrhage.Methods: Prospective studies have been conducted on104patients with intracranialhemorrhage in our hospital from February2011to November2012. According towhether the patients have hypertension disease or not, they were divided intohypertensive intracerebral hemorrhage group and non-hypertensive intracerebralhemorrhage group. After the patients were admitted, emergency surgery was operatedwithin24hours, and their invasive and non-invasive blood pressure were monitored(once an hour, without vasoactive drugs). The blood pressure variability (SD, ARV)was counted around the clock, to compare the correlation and variability betweeninvasive and noninvasive blood pressure. After the patients left the hospital for threemonths, the Glasgow outcome scale (GOS) had been evaluated, and the relationshipbetween blood pressure variability and early prognosis of patients were analyzed.Results:(1) Invasive and noninvasive blood pressure variability had a good correlation in54cases of patients with intracranial hemorrhage. Spearman rank correlation analysisshowed that24hSBP SD,24hDBP SD,24hSBP ARV,24hDBP ARV correlationcoefficients were0.844,0.737,0.818,0.708(P<0.001).(2) Compared with non-hypertensive intracerebral hemorrhage group, the patients inhypertensive intracerebral hemorrhage group were relatively older (59/50years old,P=0.005) and had many cases of rupturing into the ventricle of brain (58.82%/3.77%,P<0.001). Average blood pressure and blood pressure variability were also high,which were24hSBP (132.06±13.96/124.15±14.13mmHg, P=0.005),24hDBP(71.61±9.93/65.92±9.60mmHg, P=0.004),24hSBP SD (14.88/9.40, P＜0.001), 24hDBP SD (8.38/7.01, P=0.004), and24hSBP ARV (11.22/7.09, P＜0.001),24hDBPARV (6.35/5.13, P＜0.001).(3)Single-factor and Logistic regression analysis showed that blood pressurevariability and poor prognosis of the patients with intracranial hemorrhage waspositively correlated. Hypertensive intracerebral hemorrhage group24hSBP SD (OR,10.380;95%CI,1.477-72.966; P=0.019),24hDBP SD (OR,13.467;95%CI,1.766-102.686; P=0.012),24hSBP ARV (OR,13.417;95%CI,2.608-69.010;P=0.002); Non-hypertensive intracerebral hemorrhage group,24hSBP SD (OR,55.135;95%CI,7.733-393.107, P＜0.001),24hSBP ARV(OR,6.033;95%CI,1.688-21.558; P=0.006).Conclusion:(1) Non-invasive blood pressure variability can be used as reliableindicators for monitoring.(2) Whether patients with intracranial hemorrhage hadconcomitant hypertension or not, postoperative short-term blood pressure variabilitywas associated with recent prognosis.