缺血性脑卒中患者急性期血压管理研究进展
Advances in the Study of Blood Pressure Management in Acute Phase of Ischemic Stroke Patients
DOI: 10.12677/ACM.2021.111007, PDF,   
作者: 钟介石, 韩剑虹*：昆明医科大学第二附属医院神经内科，云南 昆明
关键词: 脑梗死；血压；研究进展；Cerebral Infarction； Blood Pressure； Research Progress
摘要: 脑卒中已经成为威胁我国国民健康的首要疾病，其中急性缺血性卒中是最常见的卒中类型。血压控制在卒中的一级预防及二级预防中的作用是相对肯定的，但是关于卒中急性期的血压调控目前还存在争议，是否需要进行降压、降压幅度、降压时机、药物选择等问题仍然无统一定论，本文对缺血性脑卒中患者急性期血压调控问题进行综述，旨在为缺血性卒中患者急性期个体化血压调控提供一定依据。
Abstract: Stroke has become a major disease threatening the health of Chinese people, among which acute ischemic stroke is the most common type of stroke. The role of blood pressure control in the primary and secondary prevention of stroke is relatively positive, but the issue of blood pressure control in the acute ischemic stroke remains controversial, and whether it is necessary to reduce blood pressure, the amplitude, the opportunity, the drug selection are still inconclusive. This article will review the blood pressure control in acute ischemic stroke, in order to provide some evidence for individual blood pressure regulation in patients of ischemic stroke.
文章引用：钟介石, 韩剑虹. 缺血性脑卒中患者急性期血压管理研究进展[J]. 临床医学进展, 2021, 11(1): 42-48. https://doi.org/10.12677/ACM.2021.111007

参考文献

[1] 中国脑卒中防治报告2019编写组. 《中国脑卒中防治报告2019》概要[J]. 中国脑血管病杂志, 2020, 17(5): 272-281.
[2] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682.
[3] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑血管病一级预防指南2019[J]. 中华神经科杂志, 2019(9): 684-709.
[4] 黄久仪, 王文志. 脑血管健康管理与脑卒中早期预防专家共识[J]. 中华健康管理学杂志, 2017, 11(5): 397-407.
[5] Whelton, P.K., Carey, R.M., Aronow, W.S., et al. (2018) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 138, 529-533. [Google Scholar] [CrossRef] 
[6] 王拥军, 王春雪, 缪中荣. 中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J]. 中华神经科杂志, 2015, 48(4): 258-273.
[7] 谭燕, 刘鸣, 王清芳, 等. 脑卒中急性期血压变化及其影响因素[J]. 2005(11): 701-705.
[8] 张文波. rt-PA静脉溶栓治疗急性缺血性脑卒中的血压变化及对预后的影响[J]. 脑与神经疾病杂志, 2017, 25(6): 358-361.
[9] 杨鹏飞, 张永巍, 解炯. 脑卒中院前急救诊疗指导规范[J]. 中华医学杂志, 2018, 98(39): 3138-3147.
[10] 刘国超, 姚键, 杨晓燕. 不同类型脑梗死患者急性期血压调控对预后的影响[J]. 中国实用神经疾病杂志, 2013, 16(4): 16-19.
[11] Powers, W.J., Rabinstein, A.A., Ackerson, T., et al. (2019) Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke, 50, e344-e418. [Google Scholar] [CrossRef] 
[12] Potter, J.F., Robinson, T.G., Ford, G.A., et al. (2009) Controlling Hypertension and Hypotension Immediately Post-Stroke (CHHIPS): A Randomised, Placebo-Controlled, Double-Blind Pilot Trial. The Lancet Neurology, 8, 48-56. [Google Scholar] [CrossRef] 
[13] 陈林. 保护性早期降压策略对脑卒中急性期患者神经功能恢复及预后的影响[J]. 医学临床研究, 2017, 34(6): 1200-1202.
[14] Jillella, D.V., Calder, C.S., Uchino, K., et al. (2020) Blood Pressure and Hospital Discharge Outcomes in Acute Ischemic Stroke Patients Undergoing Reperfusi on Therapy. Journal of Stroke and Cerebrovascular Diseases, 29, 105-211. [Google Scholar] [CrossRef] [PubMed]
[15] Van Den Berg, S.A., Uniken Venema, S.M., Mulder, M., et al. (2020) Admission Blood Pressure in Relation to Clinical Outcomes and Successful Reperfusion after Endovascular Stroke Treatment. Stroke, 51, 3205-3214. [Google Scholar] [CrossRef] 
[16] Robinson, T.G., Potter, J.F., Ford, G.A., et al. (2010) Effects of Antihypertensive Treatment after Acute Stroke in the Continue or Stop Post-Stroke Antihypertensives Collaborative Study (COSSACS): A Prospective, Randomised, Open, Blinded-Endpoint Trial. The Lancet Neurology, 9, 767-775. [Google Scholar] [CrossRef] 
[17] Sandset, E.C., Bath, P.M., Boysen, G., et al. (2011) The Angiotensin-Receptor Blocker Candesartan for Treatment of Acute Stroke (SCAST): A Randomised, Placebo-Controlled, Double-Blind Trial. The Lancet, 377, 741-750. [Google Scholar] [CrossRef] 
[18] He, J., Zhang, Y., Xu, T., et al. (2014) Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Patients with Acute Ischemic Stroke: The CATIS Randomized Clinical Trial. JAMA, 311, 479-489. [Google Scholar] [CrossRef] [PubMed]
[19] Enos Trial Investigators (2015) Efficacy of Nitric Oxide, with or without Continuing Antihypertensive Treatment, for Management of High Blood Pressure in Acute Stroke (ENOS): A Partial-Factorial Randomised Controlled Trial. The Lancet, 385, 617-628. [Google Scholar] [CrossRef] 
[20] Meng, L., Ovbiagele, B., Hong, K.S., et al. (2015) Effect of Blood Pressure Lowering in Early Ischemic Stroke: Meta-Analysis. Stroke, 46, 1883-1889. [Google Scholar] [CrossRef] 
[21] Koenig, M.A., Geocadin, R.G., De Grouchy, M., et al. (2006) Safety of Induced Hypertension Therapy in Patients with Acute Ischemic Stroke. Neurocritical Care, 4, 3-7. [Google Scholar] [CrossRef] 
[22] Leonardi-Bee, J., Bath, P.M., Phillips, S.J., et al. (2002) Blood Pressure and Clinical Outcomes in the International Stroke Trial. Stroke, 33, 1315-1320. [Google Scholar] [CrossRef] 
[23] He, M., Cui, B., Wu, C., et al. (2018) Blood Pressures Immediately Following Ischemic Strokes Are Associated with Cerebral Perfusion and Neurologic Function. Journal of Clinical Hypertension (Greenwich, Conn), 20, 1008-1015. [Google Scholar] [CrossRef] [PubMed]
[24] 蒋建平, 陈红, 张磊, 等. 老年缺血性脑卒中急性期血压与预后的关系[J]. 实用老年医学, 2020, 34(2): 163-166.
[25] 国家卫生健康委员会急诊医学质控中心, 中国医师协会急诊医师分会, 世界中医药学会联合会急症专业委员会. 中国急性缺血性脑卒中急诊诊治专家共识[J]. 中国急救医学, 2018, 38(4): 281-287.
[26] 刘丽萍, 陈玮琪, 段婉莹, 等. 中国脑血管病临床管理指南(节选版)——缺血性脑血管病临床管理[J]. 中国卒中杂志, 2019, 14(7): 709-726.
[27] 国家卫生计生委脑卒中防治工程委员会. 中国缺血性脑卒中急性期诊疗指导规范[EB/OL].
http://guide.medlive.cn/guideline/14161, 2017-05.
[28] 国家卫生计生委脑卒中防治工程委员会. 中国脑卒中防治血压管理指导规范[J]. 实用心脑肺血管病杂志, 2017, 25(10): 7-17.
[29] Powers, W.J., Rabinstein, A.A., Ackerson, T., et al. (2018) 2018 Guidelines for the Early Management of Patients with Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke, 49, e46-e99. [Google Scholar] [CrossRef] 

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