摘要
目的探讨昼夜动态血压变化与脑白质疏松症(LA)的相关性。方法回顾性分析脑血管病危险因素筛查研究中的144例患者,根据头部MRI结果分为LA组(80例)和非LA组(64例)。采用美国DP5000型动态血压监测仪监测患者的血压水平,包括昼夜收缩压(24 hSBP)、昼夜舒张压(24 hDBP)、白昼收缩压(DSBP)、白昼舒张压(DDBP)、夜晚收缩压(NSBP)、夜晚舒张压(NDBP);血压变异性(BPV)参数包括白昼收缩压标准差(DSBP-SD)和舒张压标准差(DDBP-SD)、夜晚收缩压标准差(NSBP-SD)和舒张压标准差(NDBP-SD)。根据DSBP和NSBP判定血压昼夜节律,同时比较两组动态血压参数以及血压昼夜节律分型的差异。结果①LA组昼夜SBP、DSBP、DDBP、NSBP、DSBP-SD高于非LA组,差异有统计学意义(P<0.05)。②非杓型和超杓型患者的LA发生率高于杓型患者(63.0%和68.4%比38.5%),差异有统计学意义(P<0.05)。③Binary Logistic回归分析显示,DSBP(OR=1.070;95%CI:1.024～1.117)和DSBP-SD(OR=1.324;95%CI:1.129～1.552)增高是LA的独立危险因素。结论血压水平、血压变异性及血压昼夜节律是LA的重要影响因素,其中DSBP、DSBP-SD增高是LA的独立危险因素。
Objective To investigate the correlation between day and night ambulatory blood pres- sure changes and leukoaraiosis （LA）. Methods A total of 144 patients were analyzed retrospectively in the screening study of risk factors for cerebrovascular disease. The patients were divided into either a LA group （n = 80） or a non-LA group （n = 64 ） according to the brain magnetic resonance imagine （MRI） findings. The ambulatory blood pressure monitor was used to measure the blood pressure level parameters of the patients, including 24-hour systolic blood pressure （SBP）, 24-hour diastolic blood pressure （DBP）, daytime systolic blood pressure （ DSBP）, daytime diastolic blood pressure （ DDBP）, night systolic blood pressure （NSBP） , and night diastolic blood pressure （NDBP）. The blood pressure variability （BPV） pa- rameters included the standard deviation of DSBP （ DSBP-SD）, DDBP-SD, NSBP-SD, and NDBP-SD. At the same time, the differences of the ambulatory blood pressure parameters and the typing of blood pressure rhythm were compared between the 2 groups. Results （~）The levels of 24-hour SBP, DSBP, DDBP, NSBP, and DSBP-SD in the LA group were higher than those in the non-LA group. There were significant differences （ P 〈 0.05 ）. （2）The incidence of LA in the non-dipper and ultra-dipper patients was higher than that in the dipper patients. There were significant differences （ P 〈 0.05 ）. （3）Binary logistic regression analysis indicated that increased DSBP （ OR = 1. 070 ; 95% CI 1. 024 -1. 117 ） and DSBP-SD （ OR = 1. 324 ;95%CI 1. 129-1.552） were the independent risk factors for LA. Conclusion The blood pressure level, BPV and blood pressure rhythm are the important influencing factors of LA, in which increased DSBP and DSBP-SD are the independent risk factors for LA.
出处
《中国脑血管病杂志》
CAS
2013年第3期130-134,共5页
Chinese Journal of Cerebrovascular Diseases
关键词
脑白质疏松症
血压
昼夜节律
Leukoaraiosis
Blood pressure
Blood pressure rhythm
