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急性脑梗死合并冠心病患者血压变化与心脑缺血事件的相关性研究
项颖,冯丹,刘永宏,王宝梅,姬利,蔡萍,来海欧,刘莉蓉,张东亚,赵掌权,田智斌,夏辉,殷成龙,祁占宁,王飒
0
(延安大学咸阳医院神经内科;延安大学咸阳医院神心内科;延安大学咸阳医院神动态心电图室)
摘要:
目的 探讨急性脑梗死合并冠心病患者血压变化对心脑缺血事件发生的影响,寻找适合该类患者的血压范围。方法 收集急性脑梗死合并冠心病患者107例,按照有无高血压病史,分为高血压组59例和非高血压组48例,进行动态心电血压监测,再将血压值按血压水平及定义分为5个亚组:A组:~120/~80mmHg,B组:120~140/80~90mmHg,C组:140~160/90~100mmHg,D组:160~180/100~110mmHg,E组:180~/110~mmHg;缺血事件分4类:心脏缺血、脑缺血、心脑缺血及心脑均无缺血。观察各类缺血事件在各血压亚组中的分布情况。结果 高血压组中,心脑均无缺血事件主要分布在收缩压C、D组(=106.158,60.465,P<0.01)和舒张压B、C组(=79.196,55.099,P<0.01);非高血压组中,心脑均无缺血事件主要分布在收缩压B、C组(=56.090,123.131,P<0.01)和舒张压B、C组(=124.196,74.130,P<0.01)。结论 急性脑梗死合并冠心病患者心脑均无缺血事件,高血压组的合适血压范围为140~180/80~100mmHg;非高血压组的合适血压范围为120~160/80~100mmHg。
关键词:  急性脑梗死  冠心病  血压  动态心电图
DOI:
基金项目:陕西省卫生厅自然科学基础研究计划项目(S2011JC5634)
Study on the relationship between blood pressure and heart-cerebral ischemia events for acute cerebral infarction in patients with coronary heart disease
XIANG Ying,FENG Dan,LIU Yonghong,WANG Baomei,JI Li,CAI Ping,LAI Haiou,LIU Lirong,ZHANG Dongya,ZHAO Zhangquan,TIAN Zhibin,XIA Hui,YIN Chenglong,QI Zhanning,WANG Sa
(Department of Neurology, Xianyang Hospital of Yan’ an University, Xianyang 712000, Shanxi, China;Department of Cardiology, Xianyang Hospital of Yan’ an University, Xianyang 712000, Shanxi, China;Department of Electrocardiogram, Xianyang Hospital of Yan’ an University, Xianyang 712000, Shanxi, China)
Abstract:
Objective To study the effect of blood pressure changes on heart and brain ischemia in patients with acute cerebral infarction and coronary heart disease and find the range of blood pressure suitable for these patients.Methods 107 patients of acute cerebral infarction complicated with coronary heart disease were divided into hypertension group (n=59) and nonhypertension group (n=48). The patients were simultaneously monitored by ambulatory blood pressure and dynamic electrocardiogram. The blood pressure values and their corresponding ischemia events were studied. Blood pressure values are divided into five subgroups: A (~120/~80mmHg),B(120~140/80~90mmHg),C(140~160/90~100mmHg),D(160~180/100~110mmHg) and E (180~/110~mmHg). Ischemia events in four categories: heart ischemia, cerebral ischemia, heartcerebral ischemia and heartcerebral without ischemia. The distribution of different classification of cardiovascular and cerebrovascular events in each blood pressure subgroup were observed.Results Heartbrain without ischemic events of hypertension group were mainly distributed in SBP C,D group(=106.158,60.465,P<0.01) and DBP B,C group(=79.196,55.099,P<0.01). Heartbrain without ischemic events of nonhypertension group were mainly distributed in SBP B, C group=56.090,123.131,P<0.01) and DBP B, C group(=124.196,74130,P<001). Conclusion There is no heartbrain ischemia event in patients with acute cerebral infarction complicated with coronary heart disease. The appropriate range of blood pressure of hypertension group is 140~180/80~100mmHg. Nonhypertension group of appropriate blood pressure range is 120~160/80~100mmHg.
Key words:  Acute cerebral infarction  Coronary heart disease  Blood pressure  Dynamic electrocardiogram

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