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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Effect of Nitric Oxide Donors on Blood Pressure and Pulse Pressure in Acute and Subacute Stroke
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Effect of Nitric Oxide Donors on Blood Pressure and Pulse Pressure in Acute and Subacute Stroke

机译：一氧化氮供体对急性和亚急性卒中血压和脉压的影响

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摘要

High blood pressure (BP), pulse pressure (PP), and rate pressure product (RPP) are each associated independently with a poor outcome in acute ischemic stroke. Whereas nitric oxide (NO) donors, such as glyceryl trinitrate (GTN), lower blood pressure in acute ischemic stroke, their effect on other hemodynamic measures is not known. We performed a systematic review of the effects of NO donors on systemic hemodynamic measures in patients with acute /subacute stroke. Randomized controlled trials were identified from searches of the Cochrane Library, Pubmed, and Embase. Information on hemodynamic measures, including systolic BP (SBP), diastolic BP (DBP), and heart rate, were assessed, and hemodynamic derivatives of these were calculated: PP (PP = SBP -DBP), mean arterial pressure (MAP - DBP + PP/3), mid blood pressure (MBP - (SBP + DBP)/2), pulse pressure index (PPI = PP/MAP), and RPP (RPP - SBP X HR). The effect of treatment on hemodynamic measures was calculated as the weighted mean difference (WMD) between treated and control groups with adjustment for baseline. Three trials involving 145 patients were identified; 93 patients received the NO donor, GTN, and 52 patients composed the control group. Compared with placebo, GTN significantly reduced SBP (WMD, -9.80 mm Hg; P < .001), DBP {WMD, -4.43 mm Hg; P < .001), MAP (WMD, - 6.41 mm Hg; P < .001), MBP (WMD, -7.33 mm Hg; P < .001), PP (WMD, -6.11 mm Hg; P < .001), and PPI (WMD, -0.03; P = .04). GTN increased HR (WMD, +3.87 bpm; P < .001) and lowered RPP insignificantly (WMD, -323 mm Hg ·bpm; P = .14). Our findings indicate that the NO donor GTN reduces BP, PP, and other derivatives in acute and subacute stroke while increasing HR.
机译：高血压（BP），脉压（PP）和心率压积（RPP）分别与急性缺血性卒中的不良预后相关。尽管一氧化氮（NO）供体（例如三硝酸甘油酯（GTN））在急性缺血性卒中时可降低血压，但其对其他血液动力学指标的影响尚不清楚。我们对NO供体对急性/亚急性中风患者全身血液动力学指标的影响进行了系统评价。随机对照试验是从Cochrane Library，Pubmed和Embase的搜索中确定的。评估了包括收缩压（SBP），舒张压（DBP）和心率在内的血液动力学指标信息，并计算了这些指标的血液动力学指标：PP（PP = SBP -DBP），平均动脉压（MAP-DBP + PP / 3），中血压（MBP-（SBP + DBP）/ 2），脉压指数（PPI = PP / MAP）和RPP（RPP-SBP X HR）。将治疗对血液动力学指标的影响计算为治疗组和对照组之间的加权平均差（WMD），并调整基线。确定了三项涉及145例患者的试验。 93例患者接受了NO供体，GTN，52例为对照组。与安慰剂相比，GTN显着降低了SBP（WMD，-9.80 mm Hg; P <.001），DBP {WMD，-4.43 mm Hg; P <.001），MAP（WMD，-6.41 mm Hg; P <.001），MBP（WMD，-7.33 mm Hg; P <.001），PP（WMD，-6.11 mm Hg; P <.001）和PPI（WMD，-0.03; P = .04）。 GTN增加了心率（WMD，+ 3.87 bpm; P <.001），而RPP却没有明显降低（WMD，-323 mm Hg·bpm; P = .14）。我们的研究结果表明，NO供体GTN可以降低急性和亚急性卒中中的BP，PP和其他衍生物，同时增加HR。

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