A Study Of The Effect Of BP Management In Acute Cerebral Infarction On The Attack Of Post-Stroke Depression

ObjectiveTo conduct blood pressure(short for BP hereafter)managementin patients with acute cerebral infarction complicated with hypertension,to study and analyze the effect of BP management in acute phase of cerebral infarction on the attack of post-stroke depression and the patients’ disease prognosis.MethodStrictly follow the inclusion and exclusion standard in this study,and 120 cases of patients with acute cerebral infarction complicated with hypertension were selected,among which 80 cases of male patients,and 40 cases of female patients,their age was between 40 and 80 years old,the patients were randomly divided into two groups which was observation group and control group,respectively;Thereinto,the observation group had 60 patients,and there were 60 patients in the controlgroup.The basic conditions of patients in two groups included the basic data such as gender,age,cultural background,family relations,family economy status etc.and their admitting blood pressure,neurological impairment,activities of daily living,self-care rating and mental state had comparability,their comparative difference had no statistical significance(P>0.05).Skull CT or skull MRI inspection,ECG,UCG,abdominal B-mode ultrasound,cervical and upper extremity vascular ultrasound,hematological examination,urine and stool routine examination were conducted on these patients.Conventional acute cerebral infarction related basic treatment was given to the control group,the main measures included the application of fighting against thrombus,improving cerebral circulation,eliminate oxygen free radicals and nerve nutrition medications,individualized active exercise was conducted,blood pressure was monitored,and conventional blood pressure management was adopted.Acute cerebral infarction BP management was given to the observation group on the basis of cerebral infarction related basic treatment and individualized active training as that in the control group.The BP management of cerebral infarction in acute phase: 24-48 hr post the attack,the systolic pressure >220mmHg,diastolic pressure >120mmHg or mean arterial pressure>130 mmHg,temporary anti-hypertensive expectant therapy was employed.After 48 hr and within 7 days of medical course,the systolic >180mmHg,diastolic pressure>120mmHg or mean arterial pressure>120mmHg,temporary expectant anti-hypertensive therapy was utilized.After one week of medical course,the patients’ daily antihypertensive therapy was returned and the average blood pressure was maintained between 140~150mmHg/90 and 100 mmHg.Anti-hypertensive therapy treatment was given to the patients in case of their blood pressure exceeding the risk value(180/100mmHg)in the blood pressure monitor.The blood pressure at admission,48 hr,1 week,2 week and 12 week of the patients in cerebral infarction acute phase in both groups were recorded.Evaluation was conducted by utilizing the NIHSS scale,Barthel Index(BI index)and HAMD scale.Relevant data was disposed by statistical method.ResultThe patients’ NIHSS score on neurological impairment were studied and observed on the 12 th week,the observation group had improvement compared with the control group,there was statistical difference(P<0.05).The observation group had improvement on the BI score compared with the control group,there was statistical difference(P<0.05).The observation group had a lower degree of dependence on the self-care ability level distribution compared to the control group,there was statistical difference(P<0.05),the patients in the observation group had a comparatively lower degree of dependence on the self-care ability.The observation group had a lower mark in the HAMD score,there was statistical difference(P<0.05),the patients in the observation group had a lower mark in the HAMD scale;the severity of depression was comparatively lighter than those in the control group.The observation group had a lower incidence of post-stroke depression,there was statistical difference(P<0.05),the patients in the observation group had a lower incidence of post-stroke depression.After 12 weeks of observation,reexamination with the blood routine,renal function,electrolyte,myocardial enzyme and DIC was done and had no apparent aberrant changes were noted.During the observation period,mild reactions such as gingival bleeding,dizziness,nausea and constipation were occasionally occurred to some patients;yet they were tolerable to the patients,and none severe adverse reaction,life threatening or death happened.ConclusionThe blood pressure management in the acute phase of cerebral infarction conducted to patients with acute cerebral infarction complicated with hypertension could reduce the attack of post-stroke depression,lesson the extent of depressive symptoms,decrease the degree of neurological impairment,improve the patient’s daily living and motion ability,boost the patients’ level of self-care,lower the degree of dependence;and the patients’ disease prognosis is improved.