急性缺血性卒中超早期血压管理研究进展(Research Progress on Ultra-Early Blood Pressure Management in Acute Ischemic Stroke)
卒中是全球范围内致残和致死的主要病因之一，其中缺血性卒中占卒中的70%以上，是全球重大公共卫生问题之一。急性缺血性卒中（acute ischemic stroke，AIS）患者发病早期常出现血压升高，大量观察性研究提示血压升高与AIS患者预后不良相关。AIS超早期血压管理的核心挑战在于脑血流自动调节受损背景下血压波动对缺血半暗带的双重影响，合理的血压管理策略是改善患者预后的关键因素之一。当前，在AIS超早期血压管理领域，在降压时机的抉择、目标血压值的个体化设定，以及不同降压策略对脑灌注和再灌注损伤的影响等方面仍存在广泛争议。鉴于此，本文对AIS超早期血压管理的最新研究进展进行梳理与探讨，以期...
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Department of Chinese Journal of Stroke
2025-07-01
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| Series: | Zhongguo cuzhong zazhi |
| Subjects: | |
| Online Access: | https://www.chinastroke.org.cn/CN/10.3969/j.issn.1673-5765.2025.07.005 |
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| Summary: | 卒中是全球范围内致残和致死的主要病因之一，其中缺血性卒中占卒中的70%以上，是全球重大公共卫生问题之一。急性缺血性卒中（acute ischemic stroke，AIS）患者发病早期常出现血压升高，大量观察性研究提示血压升高与AIS患者预后不良相关。AIS超早期血压管理的核心挑战在于脑血流自动调节受损背景下血压波动对缺血半暗带的双重影响，合理的血压管理策略是改善患者预后的关键因素之一。当前，在AIS超早期血压管理领域，在降压时机的抉择、目标血压值的个体化设定，以及不同降压策略对脑灌注和再灌注损伤的影响等方面仍存在广泛争议。鉴于此，本文对AIS超早期血压管理的最新研究进展进行梳理与探讨，以期为临床实践提供更具价值的参考。Abstract: Stroke is one of the leading causes of disability and death worldwide, with ischemic stroke accounting for over 70% of all stroke cases, making it a major global public health issue. Patients with acute ischemic stroke (AIS) often exhibit elevated blood pressure in the early phase after onset, and numerous observational studies suggest that elevated blood pressure is associated with poor prognosis. The core challenge in ultra-early blood pressure management for AIS lies in the dual-directional impact of blood pressure fluctuations on the ischemic penumbra against the backdrop of impaired cerebral autoregulation. A rational blood pressure management strategy is one of the key factors to improve patient outcomes. Currently, significant controversies persist regarding the timing of blood pressure lowering, individualized blood pressure target setting, and the effects of different antihypertensive strategies on cerebral perfusion and reperfusion injury in the ultra-early phase of AIS. Given this, this article reviews and discusses the latest research progress in ultra-early blood pressure management for AIS, aiming to provide more valuable references for clinical practice. |
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| ISSN: | 1673-5765 |