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首页> 外文期刊>Stroke: A Journal of Cerebral Circulation >Systolic blood pressure after intravenous antihypertensive treatment and clinical outcomes in hyperacute intracerebral hemorrhage: The stroke acute management with urgent risk-factor assessment and improvement-intracerebral hemorrhage study
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Systolic blood pressure after intravenous antihypertensive treatment and clinical outcomes in hyperacute intracerebral hemorrhage: The stroke acute management with urgent risk-factor assessment and improvement-intracerebral hemorrhage study

机译：静脉高压降压治疗后的收缩压和超急性脑出血的临床结局：中风急性发作并进行紧急危险因素评估和改善性脑出血研究

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BACKGROUND AND PURPOSE - : Blood pressure (BP) lowering is often conducted as part of general acute management in patients with acute intracerebral hemorrhage. However, the relationship between BP after antihypertensive therapy and clinical outcomes is not fully known. METHODS - : Hyperacute (<3 hours from onset) intracerebral hemorrhage patients with initial systolic BP (SBP) >180 mm Hg were included. All patients received intravenous antihypertensive treatment, based on predefined protocol to lower and maintain SBP between 120 and 160 mm Hg. BPs were measured every 15 minutes during the initial 2 hours and every 60 minutes in the next 22 hours (a total of 30 measurements). The mean achieved SBP was defined as the mean of 30 SBPs, and associations between the mean achieved SBP and neurological deterioration (≥2 points' decrease in Glasgow Coma Score or ≥4 points' increase in National Institutes of Health Stroke Scale score), hematoma expansion (>33% increase), and unfavorable outcome (modified Rankin Scale score 4-6 at 3 months) were assessed with multivariate logistic regression analyses. RESULTS - : Of the 211 patients (81 women, median age 65 [interquartile range, 58-74] years, and median initial National Institutes of Health Stroke Scale score 13 [8-17]) enrolled, 17 (8%) showed neurological deterioration, 36 (17%) showed hematoma expansion, and 87 (41%) had an unfavorable outcome. On multivariate regression analyses, mean achieved SBP was independently associated with neurological deterioration (odds ratio, 4.45; 95% confidence interval, 2.03-9.74 per 10 mm Hg increment), hematoma expansion (1.86; 1.09-3.16), and unfavorable outcome (2.03; 1.24-3.33) after adjusting for known predictive factors. CONCLUSIONS - : High achieved SBP after standardized antihypertensive therapy in hyperacute intracerebral hemorrhage was independently associated with poor clinical outcomes. Aggressive antihypertensive treatment may ameliorate clinical outcomes.
机译：背景与目的-：急性脑出血患者通常将血压（BP）降低作为一般急性治疗的一部分。然而，抗高血压治疗后的血压与临床结果之间的关系尚不完全清楚。方法-：包括初始收缩压（SBP）> 180 mm Hg的超急性（发病后3小时内）脑出血患者。根据预定义的方案，所有患者均接受静脉降压治疗，以将SBP降低并维持在120至160 mm Hg之间。在最初的2个小时内每15分钟测量一次BP，在接下来的22个小时内每60分钟测量一次BP（总共进行30次测量）。平均达到的SBP定义为30个SBP的平均值，以及平均达到的SBP与神经系统恶化之间的关联（格拉斯哥昏迷评分降低≥2分或美国国立卫生研究院卒中量表评分提高≥4分），血肿使用多因素Logistic回归分析评估了患者的扩张（增加了33％以上）和不利的结果（在3个月时改良的Rankin量表评分为4-6）。结果-：招募了211例患者（81名女性，中位年龄65 [四分位间距，58-74]岁，美国国立卫生研究院卒中量表初始得分中位数13 [8-17]），其中17例（8％）表现出神经系统疾病恶化，有36例（17％）显示血肿扩大，有87例（41％）有不良结局。在多元回归分析中，平均SBP与神经系统恶化（赔率，4.45; 95％置信区间，每10 mm Hg增量2.03-9.74），血肿扩大（1.86; 1.09-3.16）和不良结局（2.03）独立相关。 ; 1.24-3.33）调整已知的预测因素后。结论-：标准化的抗高血压治疗后超急性脑出血取得的高SBP与不良的临床预后相关。积极的抗高血压治疗可改善临床疗效。

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