急性缺血性脑卒中不同水平血压管理应用效果及其对近期预后及认知功能的影响

摘要 目的：急性缺血性脑卒中不同水平血压管理应用效果及其对近期预后及认知功能的影响。方法：选择我院2021年7月-2022年9月收治的急性缺血性脑卒中患者180例作为本次研究对象，分为对照组及观察1组、观察2组，对照组不进行降压治疗，将观察1组患者急性期血压控制120/80 mmHg，观察2组血压控制在140/90 mmHg，观察各组患者临床治疗效果、近期预后改善情况及对认知功能的影响。采用美国国立卫生研究院脑卒中量表对患者治疗效果和NIHSS测量评定。结果：治疗后各组NIHSS评分较入院时明显降低，且治疗期间NIHSS评分变化12 d＞8 d＞4 d，观察1组、观察2组患者治疗4 d、8 d、12 d后NIHSS评分较对照组明显降低（P＜0.05）；治疗后观察1组和观察2组总有效率较对照组患者显著提高（P＜0.05），观察1组与观察2组相比无统计学意义（P＞0.05）；观察1组、观察2组患者治疗后MMSE和MoCA评分较对照组明显升高（P＜0.05），观察1组和观察2组MMSE和MoCA评分差异无统计学意义（P＞0.05）。Logistic回归分析提示血压控制和入院NIHSS评分则与脑卒中患者近期预后显著相关（P＜0.05）。结论：急性脑缺血性脑卒中急性期对患者进行血压控制能够有效提高患者预后效果，促进患者神经功能恢复，但血压控制120/80 mmHg与140/90 mmHg血压管理方案效果相似。

The Application Effect of Different Levels of Blood Pressure Management in Acute Ischemic Stroke and its Impact on Short-term Prognosis and Cognitive Function

ABSTRACT Objective: To investigate the effectiveness of different levels of blood pressure management in acute ischemic stroke and its impact on short-term prognosis and cognitive function. Methods: 180 patients with acute ischemic stroke admitted to our hospital from July 2021 to September 2022 were selected as the subjects of this study. They were divided into a control group, observation group 1,and observation group 2. The control group did not receive antihypertensive treatment. The acute blood pressure of observation group 1 was controlled at 120/80 mmHg, and the blood pressure of observation group 2 was controlled at 140/90 mmHg. The clinical treatment effect, recent prognosis improvement, and impact on cognitive function of each group of patients were observed.Evaluate the treatment efficacy and NIHSS measurement of patients using the National Institutes of Health Stroke Scale. Results: After treatment, the NIHSS scores of each group were significantly lower than those at admission, and the changes in NIHSS scores during the treatment period were 12 days>8 days>4 days. The NIHSS scores of patients in observation group 1 and observation group 2 were significantly lower than those in the control group after treatment for 4 days, 8 days, and 12 days(P<0.05); After treatment, the total effective rate of observation group 1 and observation group 2 was significantly improved compared to the control group patients(P<0.05), and there was no statistically significant difference between observation group 1 and observation group 2(P>0.05); After treatment, the MMSE and MoCA scores of patients in observation group 1 and observation group 2 were significantly higher than those in the control group(P<0.05). There was no statistically significant difference in MMSE and MoCA scores between observation group 1 and observation group 2(P>0.05). Logistic regression analysis showed that blood pressure control and admission NIHSS score were significantly correlated with the short-term prognosis of stroke patients(P<0.05). Conclusion: Blood pressure control in patients with acute ischemic stroke during the acute phase can effectively improve the prognosis and promote the recovery of neurological function.However, the blood pressure control plan of 120/80 mmHg and 140/90 mmHg has similar effects.