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Research purposes a large sample, multi-center clinical data analysis to explore the relationship between blood pressure levels and neurological deficits in acute ischemic stroke and hemorrhagic stroke patients admitted to hospital. Eligible ischemic stroke in patients with acute blood pressure intervention observed acute ischemic stroke-term changes in blood pressure phenomenon, to explore the relationship between procedural blood pressure control and clinical outcomes. Research methods. Retrospective case-control study, to January 1, 2000 to 2008, 3231 cases hospitalized in four hospitals in three cities of Tai'an City, Shandong Province, Weifang and Zibo City of Neurology acute stroke patients as research subjects. Ischemic stroke and hemorrhagic stroke, according to the imaging findings are divided into a unified design cases questionnaire, patients were collected 24 hours after admission (h) basic personal information, lifestyle information, medical history information, results of laboratory tests, admission blood pressure levels, imaging data and neurological score (NIHSS). With the establishment of a database EpiDate software SPSS13.0 software for statistical analysis. The two groups were compared by t test, compared by x2 test. NIHSS divided into two levels, that NIHSS lt; 5 (mild) and NIHSS gt; (in severe). Multi-factor non-conditional logistic regression analysis, to calculate systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels NIHSS gt; 5 ratio (OR) and 95% confidence intervals (95% CI). 2 randomized controlled clinical study, as research subjects met the inclusion criteria in the People's Liberation Army Hospital of Neurology eighty-eight hospitalized on May 1, 2009 to 2009, 49 patients with ischemic stroke. Were randomly divided into the experimental group and the control group, the experimental group to take procedural antihypertensive therapy, take conventional treatment control group (in principle, to buck); patients with intermittent measure and record the study 14 days after admission (discharged) blood pressure; collection demographic information, admission blood pressure levels, admission laboratory data, medical history information, and clinical outcome (NIHSS, MRs) information. With the establishment of a database EpiDate software SPSS13.0 software for statistical analysis. The two groups were compared by t test, compared by x2 test; calculated separately and compare the implementation of blood pressure lowering treatment (14 days, 1 month, 3-month mortality NIHSS, MRs) influence on the prognosis. Results through the comparison of the general characteristics of the stroke patients, the age of the ischemic stroke group and the proportion of male were higher than the group of hemorrhagic stroke, ischemic stroke group high triglycerides (TG ) rate, low high-density lipoprotein cholesterol (HDL-C) rate, high-density lipoprotein cholesterol (LDL-C) rate, the rate of a history of diabetes, history of coronary heart disease rates were higher than hemorrhagic stroke and atrial fibrillation history Group; hemorrhagic stroke, high blood sugar rate (BG), admission systolic blood pressure, diastolic blood pressure, and admission NIHSS scores were higher than ischemic stroke group: the difference between the two groups were statistically significant (P lt; 0.05). (1) ischemic stroke patients admitted to hospital blood pressure levels NIHSS ≥ 5 OR values ??and 95% Cl: to admission the SBP lt; 140mmHg as a reference, adjust the gender, age cases SBP ≥ 180mmHg NIHSS ≥ 5 OR values ??were statistically significant (P lt; 0.05) the NIHSS ≥ 5 of the danger of the SBP lt; 140mmHg 1.64 times; multi-factor adjusted OR value (1.59) is still statistically significant. To admission DBP lt; 90mmHg as a reference, in adjusting for sex, age cases, DBP 90-99mmHg and 100-109mmHg of their NIHSS ≥ 5 OR values ??of 1.25 and 1.51, respectively, all with statistical significance (P lt; 0.05); multi-factor adjusted, DBP 100-109mmHg by the NIHSS ≥ 5, the OR value (1.34) still has a statistically significant (P lt; 0.05). (2) the blood pressure levels of hemorrhagic stroke in patients with different admission NIHSS ≥ 5 OR values ??and 95% CI: to admission the SBP lt; 140mmHg as a reference, adjusted for sex, age, SBP 160-179mmHg and ≥ 180mmHg by NIHSS ≥ 5 OR values ??of 2.46 and 2.32, respectively, were statistically significant (P lt; 0.01); After adjustment by multiple factors, all levels and blood pressure levels the NIHSS ≥ 5 OR values ??were not statistically significant (P are gt; 0.05). To admission DBP lt; 90mmHg as a reference, in the adjustment for sex, age cases in the 100-109mmHg and ≥ 110mmHg, DBP NIHSS ≥ 5 OR values ??of 2.26 and 3.04, respectively, were statistically significant (P lt; 0.01) ; After multifactorial adjustment, DBP ≥ 110mmHg NIHSS ≥ 5 OR values ??(3.01) is still statistically significant (P lt; 0.05), there are higher NIHSS ≥ 5 the risk of an increasing trend with DBP (P lt ; 0.05). 2. Experimental group and control group comparison of the different time periods blood pressure: within 72h after admission SBP, DBP fluctuates significantly, but the overall downward trend, this phenomenon exists in the experimental group and the control group at the same time, the volatility of the experimental group than in the control group slightly smaller, but the statistical analysis no significant difference (P gt; 0.05); 4-7 days the two groups was statistically significant (P lt; 0.05) decline of blood pressure in the experimental group compared with the control group, SBP more obvious; 7 days after the blood pressure stabilized, 14 days (discharged) between the two groups had no statistical significance (P gt; 0.05). 14 days (discharged), a two groups NIHSS score MRs rated, three months, two groups of mortality were not statistically significant (P gt; 0.05); NIHSS score the MRs scoring more statistically significant ( P lt; 0.05), two groups of mortality was no significant difference (P gt; 0.05). Research conclusions. (1) admission SBP ≥ 180mmHg and DBP in the 100-109mmHg with ischemic stroke NIHSS score associated. (2) The DBP ≥ 110mmHg and hemorrhagic stroke admission NIHSS score associated. 2 (1) of ischemic stroke in the acute phase of procedural buck patients 14 days (discharged) and a NIHSS score, MRs score, the fatality rate had no significant effect. NIHSS score (2) ischemic stroke in the acute phase of the program three months to improve the buck, MRs score; no significant effect on mortality in three months. Implications for research: the study of ischemic stroke blood pressure control and clinical outcomes analysis provides a lot of detailed clinical data, and provides a theoretical basis for the development of acute ischemic stroke blood pressure treatment strategies, and recycling permit the medical evidence.
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