Effect Of Blood Pressure Variation On The Prognosis Of Venous Thrombolysis In Acute Ischemic Stroke

Purpose We aimed to investigatethe relationship between blood pressure variability?BPV?and prognosis in patients with acute ischemic stroke during intravenous thrombolysis,1 hours and 24 hours after thrombolysis.Methods98 cases of acute ischemic stroke in thrombolysis time window from November 2016 to November 2017in our hospital were selected by intravenous thrombolysis with recombinant tissue plasminogen activator.There were 63 males and 35 females;between 27 to 89 years,the average age was 63.3±13.3.The NIHSS score was used to score the neurological deficit of the patients.A modified Rankin scale?modified Rankin scale,mRS?score was used to evaluate the prognosis of the patients.Blood pressure was recorded before thrombolysis,blood pressure during thrombolysis,blood pressure within 24 hours after thrombolysis.The indexes of blood pressure assessment include mean?mean?,maximum?max?,minimum?min?,extreme value?max-min?,standard deviation?SD?,coefficient of variation?CV?,continuous variability?SV?,etc.The effect of blood pressure parameters on the long-term prognosis was evaluated by logistic regression analysis under the correction of baseline data.ResultsThe prognosis of 24 hours is related to age,pre thrombolytic systolic pressure?S0?,pre thrombolytic NIHSS score,pre thrombolytic blood glucose,history of previous atrial fibrillation,intravenous antihypertensive drugs during the thrombolytic period,S mean,S max,D _SV,D _SVdrop,S mean₁,S max₁,S _SVrise1,D mean₁,D max₁,S mean₂₄,S max₂₄,S _SD24,S _CV24,S _SV24,S _SVdrop24,D mean₂₄,D max₂₄,D _SD24,D _SV24,dS _SV.Prognosis of discharge is related to age,pre thrombolytic NIHSS score,pre thrombolytic blood glucose,history of previous atrial fibrillation,history of oral anticoagulants,intravenous antihypertensive drugs during the thrombolytic period,S0,S max₂₄,S _SD24,S _CV24,S _SV24,S _SVdrop24,D min₂₄,dS _SV,discharge of the hospital with pulmonary infection and gastrointestinal bleeding.The prognosis of 30 days is related to age,pre thrombolytic NIHSS score,pre thrombolytic blood glucose,history of previous atrial fibrillation,history of oral anticoagulants,intravenous antihypertensive drugs during the thrombolytic period,S0,S mean₂₄,S max₂₄,S _SD24,S_CV24,S_SV24,S _SVdrop24,D min₂₄,D _SV24,D _SVdrop24,dS _SV,discharge of the hospital with pulmonary infection and gastrointestinal bleeding,30 days complicated with pulmonary infection and 30 days complicated with digestive tract hemorrhage.According to the results of CT or MRI in 36h after thrombolytic therapy,it was divided into Hemorrhagic Transformation?HT??9 cases?and Non HT group?89 cases?.By comparison,we found that S max-min,S _SD,S _CV,S _SV,D _SV,D _SVdrop,D _SVdrop1,S _SD24,S CV24,S SV24,S SVrise24,S SVdrop24,D max24,D SD24,D CV24,D SV24,D SVdrop24,dS SV were related to the group of HT after thrombolysis.Multiple factor Logistic regression analysis showed that the prognosis of 24 hours was related to age,pre thrombolytic NIHSS score,S _SV,S mean₁,S mean₂₄,S _SV24,S _SVdrop24,D _SD24.Prognosis of discharge is related to age,pre thrombolytic NIHSS score,S _SVdrop24.The prognosis of 30 days is related to age,pre thrombolytic NIHSS score,S _SVdrop24.S _SVdrop24Vdrop24 was an independent predictor of group HT and Non HT group.ConclusionsBPV is correlated with prognosis of 24 hours,discharge and 30 days after thrombolytic therapy.