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已发表论文
急性后循环脑梗死患者脑灌注、血压变异性与 90 天预后的关系：一项观察性研究
Authors Zhang J, Zhu D, Chang M, Luo S, Yao B, Zhu Y , Zheng Y
Received 20 December 2024
Accepted for publication 25 February 2025
Published 19 November 2025 Volume 2025:18 Pages 7061—7073
DOI https://doi.org/10.2147/IJGM.S508474
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Jingyi Zhang,1,* Dan Zhu,2,* Meiru Chang,1 Shouzhen Luo,3 Beibei Yao,3 Yuan Zhu,3 Yan Zheng1,3
1Nanjing University of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, People’s Republic of China; 2Department of General Internal Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, People’s Republic of China; 3Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yan Zheng, Nanjing University of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine Medicine, 155 Hanzhong Road, Nanjing, 210029, People’s Republic of China, Email 260019@njucm.edu.cn Yuan Zhu, Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, People’s Republic of China, Email zy1987424@163.com
Background and Purpose: Research is still underway to determine the effect of blood pressure variability (BPV) on the prognosis of acute ischaemic stroke (AIS). The posterior circulation is vulnerable to BPV due to its unique anatomy. Our study systematically evaluated the effects of daily BPV and cerebral perfusion on 90-day prognosis of patients with acute posterior circulation cerebral infarction (PCCI) and further investigated their association.
Methods: The study included 462 patients diagnosed with PCCI. Cerebral perfusion was assessed by F.MTT (focus mean transit time), rCBV (relative cerebral blood volume) and rCBF (relative cerebral blood flow). Blood pressure (BP) was recorded twice daily and the daily BPV was calculated with standard deviation (SD) and coefficient of variation (CV). Subsequently, the correlation between daily BPV, cerebral perfusion and 90-day prognosis was examined using logistic regression modelling. Potential non-linear relationships were assessed through the use of smooth curve fitting. Assessment to explore the relationship between cerebral perfusion levels and daily BPV using stepwise logistic regression analysis. Finally, mediation analysis was performed to test the relationship between CT perfusion (CTP) mediated BPV and 90-day adverse prognosis.
Results: The study included 363 participants. Multivariate logistic regression analysis revealed that higher daily BPV and poorer cerebral perfusion were negatively associated with 90-day adverse prognosis in patients with PCCI (P < 0.05). In addition, poor cerebral perfusion was associated with higher daily BPV (MAP-SD: OR 1.15, 95% CI [1.03– 1.27], P = 0.011; MAP-CV: OR 1.17, 95% CI [1.05 ~ 1.3], P = 0.004). Meanwhile, mediation analysis showed that rCBF mediated the association between daily BPV and 90-day adverse prognosis (indirect effect estimate = 0.918, direct effect estimate = 0.0621).
Conclusion: Our study demonstrated that daily BPV and cerebral perfusion were positively associated with 90-day adverse prognosis in patients with PCCI, which was partly mediated by rCBF.
Keywords: blood pressure variability, stroke, posterior circulation infarction, CT perfusion
1Nanjing University of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, People’s Republic of China; 2Department of General Internal Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, People’s Republic of China; 3Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yan Zheng, Nanjing University of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine Medicine, 155 Hanzhong Road, Nanjing, 210029, People’s Republic of China, Email 260019@njucm.edu.cn Yuan Zhu, Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, People’s Republic of China, Email zy1987424@163.com
Background and Purpose: Research is still underway to determine the effect of blood pressure variability (BPV) on the prognosis of acute ischaemic stroke (AIS). The posterior circulation is vulnerable to BPV due to its unique anatomy. Our study systematically evaluated the effects of daily BPV and cerebral perfusion on 90-day prognosis of patients with acute posterior circulation cerebral infarction (PCCI) and further investigated their association.
Methods: The study included 462 patients diagnosed with PCCI. Cerebral perfusion was assessed by F.MTT (focus mean transit time), rCBV (relative cerebral blood volume) and rCBF (relative cerebral blood flow). Blood pressure (BP) was recorded twice daily and the daily BPV was calculated with standard deviation (SD) and coefficient of variation (CV). Subsequently, the correlation between daily BPV, cerebral perfusion and 90-day prognosis was examined using logistic regression modelling. Potential non-linear relationships were assessed through the use of smooth curve fitting. Assessment to explore the relationship between cerebral perfusion levels and daily BPV using stepwise logistic regression analysis. Finally, mediation analysis was performed to test the relationship between CT perfusion (CTP) mediated BPV and 90-day adverse prognosis.
Results: The study included 363 participants. Multivariate logistic regression analysis revealed that higher daily BPV and poorer cerebral perfusion were negatively associated with 90-day adverse prognosis in patients with PCCI (P < 0.05). In addition, poor cerebral perfusion was associated with higher daily BPV (MAP-SD: OR 1.15, 95% CI [1.03– 1.27], P = 0.011; MAP-CV: OR 1.17, 95% CI [1.05 ~ 1.3], P = 0.004). Meanwhile, mediation analysis showed that rCBF mediated the association between daily BPV and 90-day adverse prognosis (indirect effect estimate = 0.918, direct effect estimate = 0.0621).
Conclusion: Our study demonstrated that daily BPV and cerebral perfusion were positively associated with 90-day adverse prognosis in patients with PCCI, which was partly mediated by rCBF.
Keywords: blood pressure variability, stroke, posterior circulation infarction, CT perfusion