| Objective:This was a retrospective study aimed to investigate the relationship of peri-and postoperative blood pressure variability (BPV) with the prognosis of carotid artery stenting. Our study would provide a novel evidence to guide the control of blood pressure in the patients with carotid artery stenting, and explore whether BPV can predict the prognosis of patients. It would provide the basis and relevan date to doctors and nurses in the Department of Neurology management, in order to control blood pressure and blood pressure variability better, selec the reliable and effective and appropriate methods for patients.The relevant data obtained provide clinical data support for the regulation of blood pressure management in these patients of Neurology. So as to establish standardized management processes for blood pressure in these patients.Methods:The research design in this study is a retrospective analysis. A total of 189 patients with the internal carotid artery stenting were collected in the Neurology Department Nanjing General Hospital of Nanjing Military Command from January 1, 2015 to February 28,2016. Baseline survey data collection collection includes age, gender, diagnosis, hospital number, ID number, time of stent implantation, smoking, drinking, hypertension, diabetes mellitus such as medical history, the rate of preoperative vascular stenosis and postoperative residual stenosi.Calculate and record the NIHSS score and mRS score (admission,seventh days after operation,3 months after operation and 6 months after operation). Using mRS score to judge the prognosis of life function and using NIHHS score to judge the prognosis of neurological function. the blood pressure were recorded,incluing three days before the operation (three times one day,6:00,14:00,19:00) and during operation (before femoral artery puncture, before and after balloon dilatation, before and after stent release), three days after operation (three times one day,6:00,14:00,19:00), and then analyzed.Results:1. BPV in the operation has nothing to do with the prognosis of 7 days after operation. It was associated with the prognosis of neurological function (γ=0.145, P=0.046).2. BPV in the operation was associated with the prognosis of 3 months after operation, whether it is the function of life or the function neurological (γ=-0.234, P=0.001 γ =-0.252,P=0.000). BPV after the operation was only associated with the prognosis of life function in 3 months after operation (γ=0.205,P=0.005).3. Logistic regression showed that intraoperative BPV in the operation is a protective factor for the prognosis of life function in 3 months (OR=0.919,95% CI 0.874-0.966, P=0.001).The NIHSS score admission (OR==1.687,95% CI 1.368-2.081,P<0.001) and BPV after the operation (OR=1.178,95% CI 1.059-1.309, P=0.002) is a risk factor for the life function prognosis of 3 months after operation.4. BPV in the operation was associated with the prognosis of 6 months after operation, whether it is the function of life or the function neurological (γ=-0.216, P=0.003 γ=0.216,P=0.003). BPV after the operation was only associated with the prognosis of life function in 6 months after operation (y=0.186, P=0.010).Conclusion:1. BPV in the operation has nothing to do with the prognosis of 7 days after operation. It was associated with the prognosis of neurological function2. BPV in the operation was protective factor for the prognosis of 3 months and 6 months after operation. If the BPV increase greater, the prognosis of life function is relatively good.3. BPV after the operation indicated the poor prognosis of carotid artery stenting 3 and 6 months after surgery.BPV after the operation was tightly correlated with the prognosis of carotid artery stenting, which reminded that it was necessary to keep it stable as soon as possible.4. Admission NIHHS score can predict the prognosis of patients earlier.5. Age is the risk factor for the prognosis of carotid artery stenting during 6-month follow-up. The older the age, the worse the prognosis.6. According to the results of this study, the change of the BPV can assist to predict prognosis in patients with internal carotid artery stenting... |
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