血压变异性和急性缺血性脑卒中患者功能转归的相关性尚不明。因此，日本学者对院内日血压变异性是否与急性缺血性脑卒中患者功能有关进行了评估，结果表明，亚急性期缺血性脑卒中患者每日血压变异性与其3个月时的功能转归有相关性。相关论文6月11日在线发表于《卒中》(Stroke)杂志。

        该研究纳入了2566例在疾病发作前功能独立且入院24小时内的首发缺血性卒中患者。每日检测患者的血压水平，用标准差(SD)、变异系数和评估其独立于平均值的变异来评估血压变异性。以3个月时患者改良Rankin量表评分≥3分定义功能转归差。

        结果显示，在校正包括年龄、性别、危险因素、卒中特征、基线严重度、溶栓治疗、抗高血压药物治疗和平均血压的多重混淆因素后，亚急性期(发病后4-10天)每日血压变异性与功能转归差独立相关。同样的趋势还见于舒张压变异性。在未接受抗高血压药物治疗的患者中，这种趋势不变。相反，在校正潜在混淆因素后，患者急性期血压变异指数和其功能转归无关。

        参考文献：Kenji Fukuda,et al. Stroke. STROKEAHA.115.009076Published online before print June 11, 2015,doi: 10.1161/STROKEAHA.115.009076

Day-by-Day Blood Pressure Variability and Functional Outcome After Acute Ischemic Stroke
Fukuoka Stroke Registry
1. Kenji Fukuda, MD, PhD,
2. Hisashi Kai, MD, PhD,
3. Masahiro Kamouchi, MD, PhD,
4. Jun Hata, MD, PhD,
5. Tetsuro Ago, MD, PhD,
6. Hiroshi Nakane, MD, PhD,
7. Tsutomu Imaizumi, MD, PhD and
8. Takanari Kitazono, MD, PhD;
9. on behalf of the FSR Investigators
1. From the Department of Medicine and Clinical Science, Graduate School of Medical Sciences (K.F., J.H., T.A., T.K.), Department of Health Care Administration and Management, Graduate School of Medical Sciences (M.K.), and Center for Cohort Studies, Graduate School of Medical Sciences (M.K., J.H., T.K.), Kyushu University, Fukuoka, Japan; Department of Cerebrovascular Disease, St. Mary’s Hospital, Kurume, Japan (K.F.); Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan (K.F., H.K., T.I.); Cerebrovascular and Neurology Center, National Hospital Organization Fukuoka-Higashi Medical Center, Koga, Japan (H.N.); and International University of Health and Welfare, Fukuoka Sannou Hospital, Fukuoka, Japan (T.I.).
1. The steering committee of the Fukuoka Stroke Registry included
-Author Affiliations
1. Correspondence to Masahiro Kamouchi, MD, PhD, Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812–8582, Japan. E-mailkamouchi@hcam.med.kyushu-u.ac.jp
Abstract
Background and Purpose—The relationship between blood pressure (BP) variability and functional outcome in patients with acute ischemic stroke remains unclear. This study aimed to elucidate whether in-hospital day-by-day BP variability is associated with functional outcome after acute ischemic stroke.
Methods—Using the Fukuoka Stroke Registry, we included 2566 patients with a first-ever ischemic stroke who had been functionally independent before the onset and were hospitalized within 24 hours. BP was measured daily, and its variability was assessed by SD, coefficients of variance, and variations independent of mean. Poor functional outcome was assessed by modified Rankin Scale scores ≥3 at 3 months.
Results—After adjustment for multiple confounding factors including age, sex, risk factors, stroke features, baseline severity, thrombolytic therapy, antihypertensive agents, and mean BP, day-by-day BP variabilityduring the subacute stage (4–10 days after onset) was independently associated with a poor functional outcome (multivariable-adjusted odds ratios [95% confidence interval] in the top versus bottom quartile of systolic BP variability, 1.51 [1.09–2.08] for SD; 1.63 [1.20–2.22] for coefficients of variance; 1.64 [1.21–2.24] for variations independent of mean). Similar trends were also observed for diastolic BP variability. These trends were unchanged in patients who were not treated with antihypertensive drugs. In contrast, no association was found between indices of BP variability during the acute stage and functional outcome after adjusting for potential confounders.
Conclusions—These data suggest that intraindividual day-by-day BP variability during the subacute stage is associated with the 3-month functional outcome after acute ischemic stroke.
STROKEAHA.115.009076Published online before print June 11, 2015,doi: 10.1161/STROKEAHA.115.009076