Relationship Between Pulse Pressure And Pulse Pressure Index And Prognosis Of Patients With Acute Ischemic Stroke

Objective:To investigate the correlation between 24-hour ambulatory pulse pressure(24hAPP)and 24-hour ambulatory pulse pressure index(24hAPPI)and the prognosis of patients with acute ischemic stroke at 14 days and 3 months,to help establish the prognosis of patients with acute ischemic stroke The model provides clinical basis for blood pressure control of clinicians and patients,improves patient prognosis,and improves quality of life.Method:1.Select patients: Patients with acute ischemic stroke who were admitted to the Department of Neurology,Affiliated Hospital of Yan'an University from November 2018 to December 2019 according to the criteria for admission.2.Record data: record the basic information of all patients after admission: name,home address,age,gender,work,contact information,family history,height,weight,and calculate body mass index(BMI);previous medical history: smoking history,drinking history,History of hyperlipidemia,history of hypertension,history of diabetes,history of stroke(hemorrhagic and ischemic);clinical data of this disease: time of admission,time spent before hospital admission,and nihss score at the time of admission.3.Calculate pulse pressure and pulse pressure index: All inpatients who meet the criteria for admission are non-invasive ambulatory blood pressure monitoring,completed within 24 hours of admission,and processed by computer supporting software to obtain24-hour mean systolic blood pressure(SBP)and 24 Hourly mean diastolic blood pressure(DBP),24-hour dynamic pulse pressure(24hAPP)= SBP-DBP;24-hour dynamic pulse pressure index(24hAPPI)= 24 hAPP / SBP.4.Follow-up and grouping: follow-up visits or telephone follow-ups wereperformed 14 days and 3 months after the onset respectively,and after 14 days the percentage of reduction in NIHSS score ?18% was defined as a good prognosis group,and <18% or exacerbation or death was defined as the prognosis Poor group;the prognosis was defined as good prognosis(mRS ? 2 points)and poor prognosis(mRS> 2points)according to the Modified Rankin Scale(mRS)after 3 months.5.Statistical method: The t-test is used for the measurement data that conforms to the normal distribution,and the ?2 test is used for the count data.The univariate analysis is performed first,and then the binary logistic multivariate analysis is performed to correct related confounding factors and find out the cause of acute ischemia.Independent risk factors for poor prognosis of cerebral stroke.Finally,ROC curve analysis chart was drawn to judge the value of pulse pressure and pulse pressure index on the prognosis of acute ischemic stroke at 14 days and 3 months,respectively.Result:1.A total of 167 patients with acute ischemic stroke were enrolled in accordance with the criteria for admission.During the experiment,7 patients were lost during follow-up,and 160 patients were eventually entered into this experimental study.2.After 14 days,the percentage reduction of the NIHSS score ?18% means that stroke has a good prognosis group(92%),and <18% or worsening means that the stroke prognosis group has 68 people(42%);age,history of hypertension,Diabetes history,time spent before hospital admission,NIHSS score at admission,24 hSBP,24hAPP,and24 hAPPI were statistically significant between the two groups with different prognosis(P<0.05),and age,time spent before admission,and NIHSS at admission The average values of the scores,24 hSBP,24hAPP,and 24 hAPPI were larger in the poor strokeprognosis group than in the good group.The results of the binary logistic multivariate analysis showed that the correction age,history of hypertension,history of diabetes,time spent in hospital,etc.After confounding factors,the prognosis of 24 hAPP and 24 hAPPI and acute ischemic stroke is still statistically significant and is an independent risk factor affecting its prognosis(24hAPP: odds ratio(OR)= 1.2333,95% IC = 1.111-1.368,P =0.000;24hAPPI: OR = 1.001,95% IC= 0.000-1.020,P = 0.020};meanwhile,age,historyof diabetes,time taken before hospital admission,NIHSS score at admission,and SBP are also independent of the prognosis of acute ischemic stroke Risk factors.Draw ROC curve model to judge pulse pressure and pulse pressure.Evaluation of the prognosis of14-day acute ischemic stroke.The results showed that the area under the curve was 0.781 and 0.747(24hAPP: 95% IC = 0.702-0.861,P <0.05;24hAPPI: 95% IC = 0.659-0.835).,P <0.05).It indicates that 24 hAPP and 24 hAPPI have certain predictive value for assessing the 14-day prognosis of acute ischemic stroke.3.After 3 months,mRS ? 2 points means 100 patients(63%)with a good stroke prognosis group,and mRS> 2 points means 60 patients(37%)with a poor stroke prognosis group;and age,time spent before hospitalization,The mean values of theNIHSS score,24 hSBP,24hAPP,and 24 hAPPI at the time of admission were larger in the poor stroke prognosis group than in the good group.The results of the binary logistic multivariate analysis showed that: in the correction age,history of hypertension,history of diabetes,hospital history The prognosis of 24 hAPP and acute ischemic stroke is still statistically significant after confounding factors such as the elapsed time.It is an independent risk factor that affects the prognosis(24hAPP: OR = 1.140,95% IC =1.054-1.232,P = 0.001)24hAPPI does not constitute a statistically significant 3-month prognosis for patients with acute ischemic cerebral infarction(24hAPPI: OR = 0.000,95% IC= 0.000-6.099,P = 0.079);mean age,history of diabetes,pre-hospital use Time,NIHSS score,and SBP at the time of consultation are also independent risk factors that affect the prognosis of acute ischemic stroke.ROC curve model is drawn to judge the value of pulse pressure and pulse pressure index on the prognosis of acute ischemic stroke at 3 months.The results showed that the areas under the curve were 0.733(95%IC = 0.645-0.822;P <0.05),indicating that 24 hAPP has certain predictive value for assessing the 3-month prognosis of acute ischemic stroke.Conclusion:1.24 hAPP and 24 hAPPI are closely related to the 14-day prognosis of patients with acuteischemic stroke and are independent risk factors affecting their prognosis.The average values of 24 hAPP and 24 hAPPI in patients with poor stroke prognosis aregreater than those in the good group.2.24 hAPP is closely related to the 3-month prognosis of patients with acute ischemic stroke and is an independent risk factor affecting its prognosis;the average value of 24 hAPP in patients with poor stroke prognosis is greater than that in the good group.3.Pulse pressure and pulse pressure index can be used to evaluate the short-term prognosis of patients with acute ischemic stroke to a certain extent,but further research is needed in future experimental research and clinical work.