目的：分析急性缺血性卒中患者不同血压水平的预后。方法选自2012年6月至2014年6月江门市中心医院神经内科首次确诊为急性缺血性卒中患者197例，其中男111例，女86例，年龄43~81岁，平均（63.71±8.54）岁。依据入院血压水平进行分组，A组（47例）血压≤140/90 mmHg（1 mmHg=0.133 kPa）；B组（99例）收缩压（SBP）141~160 mmHg，舒张压（DBP）91~100 mmHg；C组（36例）SBP 161~180 mmHg，DBP 101~110 mmHg；D组（15例）血压＞180/110 mmHg。患者入院时、入院10 d和30 d分别进行血压监测和NIHSS评分。结果入院时4个组的NIHSS评分比较，C、D两组的NIHSS评分明显高于A、B两组，差异有统计学意义（P均＜0.05）。即当SBP＞160 mmHg时，NIHSS评分明显升高。入院10 d后，197例患者中死亡20例，死亡率10.15%。D组死亡率较A组、B组和C组升高，分别为（53.33% vs.4.26%），（53.33%vs.7.07%），（53.33%vs.8.33%），差异有统计学意义（P均＜0.05）。NIHSS评分比较，C、D两组的NIHSS评分仍高于A、B两组，差异有统计学意义（P均＜0.05）。同时，A、B两组患者的血压逐渐恢复至正常。入院30 d后，4个组的NIHSS评分比较，D组的NIHSS评分明显高于其他组，差异有统计学意义（P均＜0.05）。结论缺血性卒中患者急性期血压增高，预后较差。应合理降压改善患者预后，提高生活质量。
Objective To analyze the prognosis in patients with acute ischemic cerebral apoplexy and different levels of blood pressure (BP). Methods The patients diagnosed for the first time (n=197, male 111, female 86, aged from 43 to 81 and average age=63.71±8.54) were chosen from June 2012 to June 2014, and then divided, according to their admission BP levels, into group A (n=47, BP≤140/90 mmHg), group B (n=99, SBP from 141 mmHg to 160 mmHg and DBP from 91 mmHg to 100 mmHg), group C (n=36, SBP from 161 mmHg to 180 mmHg and DBP from 101 mmHg to 110 mmHg) and group D (n=15, BP>180/110 mmHg). The level of BP and NIHSS scores were monitored at hospitalization time, and 10 d and 30 d after admission. Results The comparison in NIHSS scores showed that NIHSS scores were significantly higher in group C and group D than those in group A and group B (all P<0.05), which meant when SBP>160 mmHg, NIHSS scores increased significantly. After admission for 10 d, there were 20 cases died in total 197 patients and the mortality was 10.15%, and the mortality was higher in group D than that in group A, group B and group C [(53.33%vs. 4.26%), (53.33%vs. 7.07%), (53.33%vs. 8.33%), all P<0.05]. The comparison in NIHSS scores showed that NIHSS scores were still higher in group C and group D than those in group A and group B (all P<0.05) after admission for 10 d. At the same time, BP level was recovered to normal in group A and group B. After admission for 30 d, the comparison in NIHSS scores showed that NIHSS scores were significantly higher in group D than those in other groups (all P<0.05). Conclusion The level of BP will increase and prognosis will be poor in the patients with acute ischemic cerebral apoplexy. They should be given reasonable antihypertensive therapy for improving prognosis and quality of life.