关键词: 脑分水岭梗死; 急性期; 升压治疗; 预后

Abstract:

Objective To investigate the effect of elevated blood pressure(BP) on outcome of patients with acute cerebral watershed infarction(CWI) with systolic blood pressure(SBP) range from 140 to 160 mmHg. Methods Sixty-four successive patients with first onset acute CWI with SBP range from 140 to 160 mmHg were enrolled in this prospective analysis, which was from department of neurology, Tongji hospital, Tongji University between January 2011 and November 2014. Patients were randomly divided into elevated BP treatment group(treatment group, 29 cases) and routine treatment group(routine group, 35 cases), Dopamine was given to elevate SBP about 20 mmHg in the treatment group besides routine ischemic stroke therapy including Aspirin and Atorvastatin etc. in the first three days after admission. National Institutes of Health Stroke Scale(NIHSS) were recorded at admission and 2 weeks after admission or at discharge, modified Rankin Score(mRS) was collected for assessment of neurological function defect at 6 months after stroke. More than 46% decrease of NIHSS was defined as effectivity of elevated BP treatment 2 weeks after admission or at discharge, and mRS≤2 was defined as good outcome. Results There was no difference in baseline data including age, sex, disease time and NIHSS, etc. between two groups. The effective rate was 27.6% in treatment group and 28.6% in routine group 2 weeks after admission or at discharge. There was no statistic significance between twogroups(P =0.930). The proportion of good outcome was higher in treatment group(65.5%) than in routine group(48.6%) at six months after stroke, but there was no statistic significance(P =0.174). Conclusion Elevated BP treatment had no effect on obvious outcome in the patients with acute CWI with SBP ranged from 140 to 160 mmHg.

Key words: Cerebral watershed infarction; Elevated blood pressure treatment; Acute; Outcome