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Stroke：血压变异性增加会导致脑出血后较差的结局

2018-07-16 xing.T MedSci原创

BPV脑出血结局
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由此可见，在对ATACH-2试验进行的二次分析中，研究人员发现收缩期BPV增加与较差的长期神经结局相关。需要进一步的研究以找到能够早期识别BPV升高的患者的一种技术，并研究减小BPV的药理学或基于实验方案的方法。

收缩压变异性（BPV）增加与急性缺血性卒中后较差的结局相关，并且在脑出血后也可能产生负面影响。近日，卒中领域权威杂志Stroke上发表了一篇研究文章，研究人员试图通过急性脑出血抗高血压治疗II（ATACH-2）试验确定增加的BPV是否会产生有害的效应。

该研究的主要结局为3个月随访后改良Rankin量表得分为3至6分，次要结局是效用加权改良的Rankin量表得分。研究人员使用来自急性期（随机化后2-24小时）和亚急性期（第2、3和7天）的收缩压计算血压平均值和变异性。

该研究在急性期纳入了913例患者，亚急性纳入了877例患者。对于5种不同的收缩期BPV统计学指标，在急性期和亚急性期BPV增加与神经功能恶化之间存在一致的关联。但是收缩压平均值未发现这种关联。

由此可见，在对ATACH-2试验进行的二次分析中，研究人员发现收缩期BPV增加与较差的长期神经结局相关。需要进一步的研究以找到能够早期识别BPV升高的患者的一种技术，并研究减小BPV的药理学或基于实验方案的方法。

原始出处：

Adam de Havenon,et al. Increased Blood Pressure Variability Contributes to Worse Outcome After Intracerebral Hemorrhage An Analysis of ATACH-2.Stroke. 2018. https://doi.org/10.1161/STROKEAHA.118.022133

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    2018-07-18 12498dabm77暂无昵称

    #变异#

    0

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    2018-07-17 清风拂面

    谢谢分享学习

    0

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    2018-07-16 心介

    #血压变异性#相信未来5年是热点，不仅关心血压高与低，还要关注血压变异性才可以

    0

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    2018-07-16 邓启付

    血压变异性增加不容易维持正常血压.风险增加.

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1342501, encodeId=7fa31342501a4, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Wed Jul 18 09:55:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332283, encodeId=dda2332283b2, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Tue Jul 17 20:54:18 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031133, encodeId=f84f103113370, content=#血压变异性#相信未来5年是热点，不仅关心血压高与低，还要关注血压变异性才可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Mon Jul 16 21:55:00 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332068, encodeId=369233206840, content=血压变异性增加不容易维持正常血压.风险增加., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Mon Jul 16 20:43:13 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332060, encodeId=948a33206097, content=学习了.不错的.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Mon Jul 16 19:35:07 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332059, encodeId=67fb33205963, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Jul 16 19:24:04 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332047, encodeId=a97933204eca, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 16 19:04:04 CST 2018, time=2018-07-16, status=1, ipAttribution=)]
    2018-07-16 中医痴

    学习了.不错的.谢谢分享.

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1342501, encodeId=7fa31342501a4, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Wed Jul 18 09:55:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332283, encodeId=dda2332283b2, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Tue Jul 17 20:54:18 CST 2018, time=2018-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031133, encodeId=f84f103113370, content=#血压变异性#相信未来5年是热点，不仅关心血压高与低，还要关注血压变异性才可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Mon Jul 16 21:55:00 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332068, encodeId=369233206840, content=血压变异性增加不容易维持正常血压.风险增加., beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Mon Jul 16 20:43:13 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332060, encodeId=948a33206097, content=学习了.不错的.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Mon Jul 16 19:35:07 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332059, encodeId=67fb33205963, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Jul 16 19:24:04 CST 2018, time=2018-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=332047, encodeId=a97933204eca, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 16 19:04:04 CST 2018, time=2018-07-16, status=1, ipAttribution=)]
    2018-07-16 131****1460

    学习了受益匪浅

    0

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    2018-07-16 清风拂面

    谢谢分享学习

    0

相关资讯

Stroke：24小时血压变异性与收缩压对卒中溶栓结局的交互作用分析！

该研究表明在BP治疗前和急性BP变化过程中（即，BPV）需要更加个性化的血压管理，以使患者达到最好的可能结局。

Stroke：觉醒型卒中患者夜间平均动脉压变异性更大！

在这个单中心的研究中，研究人员发现WUS患者在入院后首个24小时期间夜间BPV要比非WUS患者要大。夜间自主神经不稳定性作为WUS一个潜在的机制值得进一步研究。

Stroke：自发性脑出血患者超急性期血压变异性与患者结局之间的相关性！

由此可见，在发病后第一分钟和第一小时内的超急性脑出血患者的BPV与不良预后存在独立相关性。在院前和急救早期这个易损阶段维持BPV稳定是未来临床试验的潜在治疗靶点。

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