关键词: 重症脑出血, 血压变异性, 血压平滑指数, 预后

Abstract: Objective To investigate the association between early blood pressure variability and prognosis in patients with severe cerebral hemorrhage. Methods A retrospective analysis of 808 patients with severe cerebral hemorrhage treated at Emergency Department Intensive Care Unit of Beijing Tiantan Hospital from 2009 to 2011 was performed. According to the design of this study,108 cases of inclusion criteria patients were selected randomly. According to the 7-day outcome after admission to EICU, the patients were divided into nonsurvivors(51 cases)and survivors (56 cases), and the blood pressure level in them was monitored in the first 24 hours. Initial systolic blood pressure(ISBP)、mean systolic blood pressure(MSBP)、mean diastolic blood pressure(MDBP)、blood pressure variability(BPV)、smoothing index(SI), the Glasgow coma scale (GCS) at admission、nicardipine total dosage in 24 hours. ResultsGCS、ISBP、MSBP、MDBP、DBPV showed no significant differences between nonsurvivors(51 cases)and survivors(6.38 ±1.74) vs (6.45±1.39)、 (201.6±16.32)mmHg vs (195.5±13.47)mmHg、(155.2±11.6)mmHg vs (153.1±10.8)mmHg、(88.5±8.2)mmHg vs (85.38±7.4)mmHg、(9.32±2.17)mmHg vs (8.91±2.58)mmHg,all P>0.05(1 mmHg=0.133 kPa),but SBPV and nicardipine total dosage (NTD) were significantly higher in nonsurvivors than survivors(14.56±6.87) vs (11.30±2.48)、(105.24±19.66)mmHg vs (78.57±11.25)mmHg,all P<0.05, smoothing index of systolic blood pressure (SISBP) and smoothing index of diastolic blood pressure (SIDBP) were significantly lower in nonsurvivors than survivors (1.125±0.124) vs (1.464±0.158)、(1.147±0.231) vs (1.263±0.245),(P<0.01,P<0.05). Conclusion The early blood pressure variability was closely related to early outcome of patients with severe cerebral hemorrhage,control early blood pressure fluctuation might improve patients, outcome.

Key words: severe cerebral hemorrhage, blood pressure variability, blood smoothing index, outcome