Trị số huyết áp lúc nhập viện và dự hậu bệnh nhân nhồi máu não cấp

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Tác giả: Đình Toàn Nguyễn, Thị Thục Anh Phạm

Ngôn ngữ: Vie

Ký hiệu phân loại: 612.1 Blood and circulation

Thông tin xuất bản: Tạp chí Nội tiết và Đái tháo đường 2021

Mô tả vật lý: 195-222

Bộ sưu tập: Metadata

ID: 396257

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Tăng huyết áp (THA) là một vấn đề phổ biến ở bệnh nhân nhồi máu não, nhiều nghiên cứu đã được thực hiện để tìm hiểu mối liên quan giữa tăng huyết áp và dự hậu bệnh nhân nhưng ảnh hưởng của tăng huyết áp đến dự hậu vẫn chưa được hiểu một cách đầy đủ. Nghiên cứu được thực hiện để khảo sát mối liên quan giữa huyết áp ghi nhận lúc nhập viện và dự hậu bệnh nhân sau 3 tháng. Phương pháp: Nghiên cứu thực hiện trên 96 bệnh nhân được chẩn đoán Nhồi máu não tại Bệnh viện Trung ương Huế từ tháng 7/2019- tháng 3/2020. Sử dụng bộ câu hỏi để thu thập thông tin nghiên cứu. Dự hậu bệnh nhân được ghi nhân sau 3 tháng kể từ khi nhồi máu não được đánh giá qua thang điểm mRankin với điểm 0 - 2 tương ứng với không tàn phế và tàn phế nhẹ, điểm 3 - 5 tương ứng với tàn phế trung bình và nặng, mRS = 6 điểm tương ứng với tử vong. Mối liên quan giữa huyết áp và dự hậu được khảo khát bằng phân tích hồi quy đa biến và đơn biến. Kết quả: Mẫu là 96 với tỷ lệ nam/nữ là 1,5:1, độ tuổi trung bình là 65,7 ± 13,7 tuổi. Tăng huyết áp tâm thu (HATT), huyết áp tâm trương (HATTr) và huyết áp trung bình (HATB) không có mối liên quan với dự hậu bệnh nhân sau 3 tháng. Kết luận: Tăng huyết áp lúc vào viện không có mối liên quan với dự hậu bệnh nhân sau 3 tháng. Kết quả này ủng hộ giả thuyết rằng huyết áp tăng lúc mới vào viện do nhiều nguyên nhân gây ra, sau khi các nguyên nhân gây tăng huyết áp thoáng qua không còn, tăng huyết áp ghi nhận trong những giờ sau mới có khả năng ảnh hưởng đến dự hậu bệnh nhân sau đột quỵ, Tóm tắt tiếng anh, Hypertension is a common problem in patients with cerebral infarction, many studies have been done to understand the association between acute blood pressure levels and long-term outcome in ischemic stroke, but its effect on outcome is not fully understood. The aim of this study was to investigate the association of acute blood pressure levels recorded at admission and long-term outcome in ischemic stroke after 3 months. Methods: A study of 96 patients diagnosed with ischemic stroke at Hue central hospital from July, 2019 to march, 2020. In this study, we use questionnaire to collect essential research information. Functional outcome at 90 days (modified Rankin scale) was recorded with score 0 - 2 corresponding to good outcome, score 3 - 5 corresponding to bad outcome, mRS scores of 6 equals death. The association between blood pressure and the outcome was assessed using logistic regression models, adjusted for confounding variables. Results: We included 96 patients with acute ischemic stroke. Male/female ratio is 1,5:1, average of age as 65,7 ± 13,7 years. Systolic blood pressure, diastolic blood pressure and mean blood pressure were not associated with patient outcome after 3 months. Conclusion: There is no association between higher blood pressure at the time of admission and outcome after 3 months in ischemic stroke. This result supports the hypothesis that hypertension at the time of admission is caused by many causes, after the causes of transient hypertension disappear, the increase in blood pressure recorded in the following hours is likely to affect long-term outcome.

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