The Study Of Correlation Between Blood Pressure Variability And Outcome After Mechanical Thrombectomy For Acute Ischemic Stroke With Different TCM Syndromes

Objective:Blood pressure variability(BPV)is a related risk factor for target organ damage,cardiovascular events and stroke.The purpose of this study is to investigate:(1)Correlation between short-term blood pressure variability and neurologic outcomes and hemorrhagic transformation after mechanical thrombectomy(MT)for acute ischemic stroke(AIS);(2)Distribution of TCM syndromes in the acute phase of ischemic stroke;(3)Correlation between short-term blood pressure variability and prognosis after MT for AIS in different syndromes.Methods:We retrospectively analyzed 126 patients with large vessel occlusive stroke who underwent MT in the Department of Encephalopathy,Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2012 to December 2018.General clinical data of selected patients were collected,the elements of TCM syndromes at admission,imaging findings before and after mechanical thrombectomy,blood pressure measured every 2 hours over 24h after MT,admission NIHSS score,and 90-day mRS score.Primary and secondary outcomes were patients' functionalstatus at 90 days measured on the modified Rankin scale and the incidence and severity of hemorrhagic transformation.The following BPV parameters were compared:the maximum,the minimum,the mean,standard deviation(SD),coefficient of variation(CV),successive variation(SV)for the systolic BP(SBP),diastolic BP(DBP)and mean arterial pressure(MAP).To evaluate the relationship between these and poor prognosis and bleeding transformation,as well as the correlation between the BPV of different syndromes and outcomes.Logistic regression analysis was used to analyze the risk factors for the prognosis of patients undergoing AIS receiving MT.Results:(1)Comparison between the good prognosis group and the poor prognosis group,the hemorrhagic transformation group and the non hemorrhagic transformation group,The results showed no significant correlation between BPV and hemorrhagic transformation and poor prognosis(P>0.05).(2)Univariate logistic regression analysis was used to analyze the risk factors affecting the prognosis of patients with AIS who underwent MT.Diastolic blood pressure standard deviation(DBP SD)was significantly associated with poor prognosis(P=0.007,OR=7.547,95%Cl:1.73-32.98).But in multiple factors logistic regression analysis,there was no statistical significance in logistic regression analysis(P>0.05).(3)Comparative analysis of BPV among wind syndrome,fiery syndrome,phlegm syndrome,wind syndrome+phlegm syndrome,phlegm syndrome+qi deficiency syndrome showed no statistical significance(P>0.05).(4)The comparison of Mean arterial pressure mean(MAPmean)between the good prognosis group and the poor prognosis group in patients with phlegm syndrome was statistically significant(P<0.05).The comparison of The standard of systolic blood pressure(SBP SD)and mean arterial pressure standard deviation(MAP SD),mean arterial pressure coefficient of variation(MAP CV)and mean arterial pressure coefficient of variation(MAP SV)between the good prognosis group and the poor prognosis group of patients with wind-syndrome+phlegm syndrome was statistically significant(P<0.05).Conclusions:(1)There was no significant correlation between BPV and early adverse prognosis and hemorrhagic transformation in patients with AIS who underwent MT.(2)MAPmean is a factor influencing the poor prognosis of patients with sputum syndrome.BPV is a risk factor affecting the prognosis of patients with wind syndrome+phlegm syndrome,among which SD being the most significant.