Effect Of Regulating Blood Pressure On The Prognosis Of Patients With Primary Cerebral Infarction

Objectives Exploring the relationship between blood pressure regulation and prognosis in patients with acute cerebral infarction.Methods Consecutively collecting 458 acute cerebral infarction patients during October,2013 to December,2015 in the second nerval medical department ward of North China University of Science and Technology Affiliated Hospital.They were randomly divided into the intervention group and the control group.According to the regulation of blood pressure within 2 years after discharge,the intervention group was divided into two sub groups(Group A—Patients whose blood pressure is up to standard after discharge.Group B—Patients whose blood pressure is not up to standard after discharge).The patients in the intervention group received antihypertensive treatment during hospitalization.Under the premise that the blood pressure was above 120/80 mmHg,the systolic blood pressure decreased by 10%to 20%within 24 hours of admission,and the blood pressure dropped to less than 140/90 mmHg after admission for seventh days,and the blood pressure was maintained at this level during hospitalization;The patients in the control group were not given the antihypertensive treatment in principle in the acute period.The Modified Rankin scale(mRS)and the United States national institutes of health stroke scale(NIHSS)was used to evaluate of patients on admission,3 months,1 years and 2 years of self-care ability of life and neurologic function defect degree,besides,death and recurrence were recorded.T test and variance analysis were used to compare the measured data.The count data were analyzed by?~2-test.The multiple factor Cox proportional risk regression model was used to analyze the relationship between different blood pressure regulation and patients' prognosis,and the value of RR and 95%CI were calculated.Results 1 In the two groups,the recurrence rate of the intervention group was relatively low at 1 year,and the recurrence rate and mortality rate of the intervention group were relatively low at 2 years,and the difference was statistically significant(P<0.05).2 Two groups of patients were compared in 3 months,1 year and 2 years,the improvement of the neurological function of the patients in the intervention group was slightly higher,and the difference was statistically significant(P<0.05).3 The multiple factor Cox regression analysis showed that antihypertensive treatment in the acute stage of initial cerebral infarction can significantly reduce the risk of death in 2 years,RR(95%CI)is2.49(1.04~5.94),and the difference is statistically significant(P<0.05).4 Compared with group B,the mortality and recurrence rate of the patients in group A were relatively low,and the difference was statistically significant(P<0.05).5 The multifactor Cox regression analysis showed that the patients with primary cerebral infarction were given the antihypertensive treatment on the basis of the acute stage,and the level of blood pressure was reached the standard in the recovery period could reduce the risk of poor long-term prognosis,RR(95%CI)is 2.40(1.25~4.61),and the difference is statistically significant(P<0.05).Conclusions 1 In the acute stage of initial cerebral infarction,antihypertensive treatment can reduce the 2 years mortality rate and the 1 and 2 years recurrence rate,which is conducive to the improvement of neurological deficit in 3 months,1 year and 2 years.2Patients with initial cerebral infarction on the basis of antihypertensive therapy at acute stage,the mortality and recurrence rate in the 1 and 2 years can be significantly reduced if the blood pressure is up to standard after discharge.It can help patients to reduce the risk of poor prognosis in 1 or 2 years.