脉压水平与脑卒中相关关系的研究进展
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摘要
脑卒中是威胁我国人民健康的重大疾病,给社会和家庭带来沉重负担。脑卒中最常见的危险因素是高血压,目前世界范围内学术界对高血压病的研究已经从收缩压和舒张压转变为脉压。有研究表明脉压对脑卒中的发生和预后有重要作用。本文总结了脉压与脑卒中相关关系的新进展,从脉压的概念、影响脉压的常见疾病、脉压增大的病理生理机制及与脑卒中发生和预后的关系、脉压减小的病理生理机制及与脑卒中预后的关系等方面进行综述,为脑卒中患者脉压水平控制提供临床依据,改善预后,提高生活质量。
Stroke is a major disease threatening people's health in China.Stroke is a major disease that threatens the health of our people and brings heavy burden to society and family.The most common risk factor for stroke is hypertension.At present, the study of hypertension has changed from systolic blood pressure and diastolic blood pressure to pulse blood pressure worldwide.Studies have shown that pulse pressure plays an important role in the occurrence and prognosis of stroke.This article summarizes the new progress in the relationship between pulse pressure and stroke.This paper reviews the concept of pulse pressure, diseases affecting pulse pressure, pathophysiological mechanism of increased pulse pressure and its relationship with occurrence and prognosis of stroke,pathophysiological mechanism of decreased pulse pressure and prognosis of stroke,to provide clinical basis for the control of pulse pressure level in stroke patients, improve prognosis and quality of life.
Stroke is a major disease threatening people's health in China.Stroke is a major disease that threatens the health of our people and brings heavy burden to society and family.The most common risk factor for stroke is hypertension.At present, the study of hypertension has changed from systolic blood pressure and diastolic blood pressure to pulse blood pressure worldwide.Studies have shown that pulse pressure plays an important role in the occurrence and prognosis of stroke.This article summarizes the new progress in the relationship between pulse pressure and stroke.This paper reviews the concept of pulse pressure, diseases affecting pulse pressure, pathophysiological mechanism of increased pulse pressure and its relationship with occurrence and prognosis of stroke,pathophysiological mechanism of decreased pulse pressure and prognosis of stroke,to provide clinical basis for the control of pulse pressure level in stroke patients, improve prognosis and quality of life.
引文
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[2]Birschel P,Ellul J,Barer D,et al.Progressing stroke awards an inter nationally agreed definition[J].Cerebrovasc Dis,2004,17(23):242-252.
[3]刘亚星,楚兰,刘伟民,等.社区人群高血压及代谢综合征与脑卒中患病的相关性分析[J].中华老年心脑血管病杂志,2012,14(9):961-964.
[4]Vemmos KN,Tsivgoulis G,Spengos K,et al.Pulse pressure in acute stroke is an independent predictor of long-term mortality[J].Cerebrovasc Dis,2004,18(1):30-36.
[5]覃天锦,王同成.老年单纯收缩期高血压患者脉压增大的机制、意义和治疗进展[J].中国心血管病研究杂志,2006,10(4):784.
[6]郭宗强,孙同文.高血压病患者并发脑卒中的危险因素研究[J].中国现代医生,2010,48(15):39-78.
[7]赵刚.脑卒中防治与血压管理[J].中华高血压杂志,2013,2(21):112-115.
[8]Liu FD,Shen XL,Zhao R.Pulse pressure as an independent predictor of stroke:a systematic review and a meta-analysis[J].Clin Res Cardiol,2016,105:677-686.
[9]Glasser SP,Halberg DL,Sands CD,Mosher A,Muntner PM,Howard G.Is pulse pressure an independent risk factor for incident stroke,reasons for geographic and racial differences in stroke[J].Am JHypertens,2015,28:987-994.
[10]Saver JL,Goyal M,Bonafe A,et al.Solitaire TM with the intention for ischemic strike(SWIFT PRIME)trial:protocol for a randomized,controlled,multicenter study comparing the Solitaire revascularization device with IV tPA with IV tPA alone in acute ischemic stroke[J].Int JStroke,2015,10(3):439-449.
[11]Cotter PE,Martin PJ,Ring L,et la.Incidence of atrial fibrillation detected by implantabie loop recorders in unexplained stroke[J].Neurolo gy,2013,80(17):1546-1550.
[12]Carrazco C,Golyan D,Kahen M,et al.Prevalence and risk factors for paroxysmal atrial fibrillation and flutter detection after cryptogenic ischemic stroke[J].J Stroke Cerebrovasc Dis,2018,27(1):203-209.
[13]Mitchell GF,Vasan RS,Keyes MJ,et.Pulse pressure and risk of new-onset strial fibrillation[J].JAMA,2007,297(7):709-715.
[14]石雪.2011例心房颤动患者的危险因素分析[D].天津:天津医科大学,2011.
[15]Benetos A,Gautier S,Labat C,et al.Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjrcts:the PARTAGE(Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population)study[J].Journal of the American College of Cardiology,2012,60(16):1503-1511.
[16]Lovett JK,Howard SC,Rothwell PI.Pulse pressure is independently associated with carotid plaque ulceration[J].Hypertens,2003,21(9):1669-1676.
[17]张茁.从SPARCL研究看脑卒中的他汀类药物治疗重要性[J].中华老年心脑血管病杂志,2012,14(5):451-452.
[18]Grabskak,NiewadaM,Sarzynska-DugoszI,et al.Pulse pressure-independent predictor of poor early out come and mortality fol-lowing is chemic stroke[J].Cerebrovas cular Diseases,2009,27(2):187-192
[19]TEMMAR M,JANKOWSKI P,PELTIER M,et al.Intraaortic pulse pressure amplification in subjects at high coronary risk[J].Hypertensi on,2010,55(2):327-332.
[20]任春霖,胡雪梅,任永生.老年原发性高血压患者动态血压指标与靶器官损害的关系[J].心血管康复医学杂志,2012,21(5):497-500.
[21]Sung-Chun Tang,Jiu-Haw Yin,Chung-Hsiang Liu.Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes:The Taiwan Stroke Registry[J].J Am Heart Assoc,2017,6:e005113.
[22]周咏梅,陶剑虹.替米沙坦对老年高血压患者血压晨峰与心脏重构的影响[J].心血管康复医学杂志,2012,21(1):67-70.
[23]韩永强,黄彦德.阿托伐他汀钙治疗颈动脉硬化的疗效观察[J].中国实用神经疾病杂志,2017,20(3):112-114.
[24]WU Y L,SAVER J L,CHEN PC,et al.Ehhect of statin use on clinical outcomes in ischemic stroke patiente with atrial fibrillation[J].Medicine,2017,96(5):e5918.
[25]Fiererr KE,Muhlmann MH,Baguet JP,et al.Intensivecholes-terol reduction lowers blood pressure and large artery stifness in isolated systolic hypertension[J].Journal of the American College of Cardiolo gy,2012,39(6):1020-1025.
[2]Birschel P,Ellul J,Barer D,et al.Progressing stroke awards an inter nationally agreed definition[J].Cerebrovasc Dis,2004,17(23):242-252.
[3]刘亚星,楚兰,刘伟民,等.社区人群高血压及代谢综合征与脑卒中患病的相关性分析[J].中华老年心脑血管病杂志,2012,14(9):961-964.
[4]Vemmos KN,Tsivgoulis G,Spengos K,et al.Pulse pressure in acute stroke is an independent predictor of long-term mortality[J].Cerebrovasc Dis,2004,18(1):30-36.
[5]覃天锦,王同成.老年单纯收缩期高血压患者脉压增大的机制、意义和治疗进展[J].中国心血管病研究杂志,2006,10(4):784.
[6]郭宗强,孙同文.高血压病患者并发脑卒中的危险因素研究[J].中国现代医生,2010,48(15):39-78.
[7]赵刚.脑卒中防治与血压管理[J].中华高血压杂志,2013,2(21):112-115.
[8]Liu FD,Shen XL,Zhao R.Pulse pressure as an independent predictor of stroke:a systematic review and a meta-analysis[J].Clin Res Cardiol,2016,105:677-686.
[9]Glasser SP,Halberg DL,Sands CD,Mosher A,Muntner PM,Howard G.Is pulse pressure an independent risk factor for incident stroke,reasons for geographic and racial differences in stroke[J].Am JHypertens,2015,28:987-994.
[10]Saver JL,Goyal M,Bonafe A,et al.Solitaire TM with the intention for ischemic strike(SWIFT PRIME)trial:protocol for a randomized,controlled,multicenter study comparing the Solitaire revascularization device with IV tPA with IV tPA alone in acute ischemic stroke[J].Int JStroke,2015,10(3):439-449.
[11]Cotter PE,Martin PJ,Ring L,et la.Incidence of atrial fibrillation detected by implantabie loop recorders in unexplained stroke[J].Neurolo gy,2013,80(17):1546-1550.
[12]Carrazco C,Golyan D,Kahen M,et al.Prevalence and risk factors for paroxysmal atrial fibrillation and flutter detection after cryptogenic ischemic stroke[J].J Stroke Cerebrovasc Dis,2018,27(1):203-209.
[13]Mitchell GF,Vasan RS,Keyes MJ,et.Pulse pressure and risk of new-onset strial fibrillation[J].JAMA,2007,297(7):709-715.
[14]石雪.2011例心房颤动患者的危险因素分析[D].天津:天津医科大学,2011.
[15]Benetos A,Gautier S,Labat C,et al.Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjrcts:the PARTAGE(Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population)study[J].Journal of the American College of Cardiology,2012,60(16):1503-1511.
[16]Lovett JK,Howard SC,Rothwell PI.Pulse pressure is independently associated with carotid plaque ulceration[J].Hypertens,2003,21(9):1669-1676.
[17]张茁.从SPARCL研究看脑卒中的他汀类药物治疗重要性[J].中华老年心脑血管病杂志,2012,14(5):451-452.
[18]Grabskak,NiewadaM,Sarzynska-DugoszI,et al.Pulse pressure-independent predictor of poor early out come and mortality fol-lowing is chemic stroke[J].Cerebrovas cular Diseases,2009,27(2):187-192
[19]TEMMAR M,JANKOWSKI P,PELTIER M,et al.Intraaortic pulse pressure amplification in subjects at high coronary risk[J].Hypertensi on,2010,55(2):327-332.
[20]任春霖,胡雪梅,任永生.老年原发性高血压患者动态血压指标与靶器官损害的关系[J].心血管康复医学杂志,2012,21(5):497-500.
[21]Sung-Chun Tang,Jiu-Haw Yin,Chung-Hsiang Liu.Low Pulse Pressure After Acute Ischemic Stroke is Associated With Unfavorable Outcomes:The Taiwan Stroke Registry[J].J Am Heart Assoc,2017,6:e005113.
[22]周咏梅,陶剑虹.替米沙坦对老年高血压患者血压晨峰与心脏重构的影响[J].心血管康复医学杂志,2012,21(1):67-70.
[23]韩永强,黄彦德.阿托伐他汀钙治疗颈动脉硬化的疗效观察[J].中国实用神经疾病杂志,2017,20(3):112-114.
[24]WU Y L,SAVER J L,CHEN PC,et al.Ehhect of statin use on clinical outcomes in ischemic stroke patiente with atrial fibrillation[J].Medicine,2017,96(5):e5918.
[25]Fiererr KE,Muhlmann MH,Baguet JP,et al.Intensivecholes-terol reduction lowers blood pressure and large artery stifness in isolated systolic hypertension[J].Journal of the American College of Cardiolo gy,2012,39(6):1020-1025.