摘要
目的研究血压变异性(blood pressure variability,BPV)与脑血管病患者脑小血管病(cerebral small vessel disease,CSVD)的相关性。方法收集我院神经内科住院的脑血管病患者341例,完成24 h动态血压监测及头颅MRI扫描,获得血压变异标准差(SD)等BPV相关参数并根据MRI上CSVD严重程度进行总体评分,根据影像学上总体CSVD评分分为CSVD 0分组55例,CSVD 1分组117例,CSVD 2分组86例,CSVD 3分组49例,CSVD≥4分组34例。收集患者一般临床资料,采用logistic回归分析BPV参数是否为CSVD的独立危险因素。结果不同CSVD评分组性别、糖尿病、高脂血症、吸烟及体质量指数比较,无统计学差异(P>0.05),而年龄、高血压比例比较,差异有统计学意义(P<0.01);不同CSVD评分组夜间收缩压SD、夜间舒张压SD、夜间动脉压SD比较,无统计学差异(P>0.05)。CSVD 0、1、2、3、≥4分组24 h收缩压SD[(11.7±3.0)mm Hg(1 mm Hg=0.133 kPa)vs(12.6±3.1)mm Hg vs(13.6±3.3)mm Hg vs(13.7±3.7)mm Hg vs(13.7±3.2)mm Hg]、昼间收缩压SD[(11.1±3.0)mm Hg vs(12.0±3.2)mm Hg vs(13.0±3.2)mm Hg vs(13.7±3.8)mm Hg vs(12.8±3.1)mm Hg]、24 h舒张压SD[(8.4±1.9)mm Hg vs(9.0±2.3)mm Hg vs(9.1±2.2)mm Hg vs(9.7±2.4)mm Hg vs(9.1±2.8)mm Hg]、昼间舒张压SD[(7.9±1.8)mm Hg vs(8.5±2.5)mm Hg vs(8.6±2.3)mm Hg vs(9.4±2.2)mm Hg vs(8.6±3.2)mm Hg]、24 h动脉压SD[(9.1±1.9)mm Hg vs(9.9±2.4)mm Hg vs(10.4±2.3)mm Hg vs(10.6±2.4)mm Hg vs(10.1±2.5)mm Hg]、昼间动脉压SD[(8.9±1.9)mm Hg vs(9.5±2.5)mm Hg vs(10.0±2.3)mm Hg vs(10.4±2.4)mm Hg vs(9.7±2.8)mm Hg]比较,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析显示,24 h收缩压SD是CSVD的独立危险因素(P=0.032)。结论24 h BPV及昼间BPV与CSVD严重程度存在一定相关性。
Objective To study the relationship between blood pressure variability(BPV)and cerebral small vessel disease(CSVD).Methods Three hundred and forty-one CSVD patients admitted to our hospital from October 2012 to August 2014 were included in this study.The SD and parameters of BPV were recorded by monitoring the 24 h ambulatory blood pressure(ABP)and brain MRI.The patients were divided into 0-score CSVD group(n=55),1-score CSVD group(n=117),2-score CSVD group(n=86),3-score CSVD group(n=49)and≥4-score CSVD group(n=34)according to the score of CSVD.Their general clinical data were recorded.Whether the BPV is an independent risk factor for CSVD was analyzed by logistic regression analysis.Results No significant difference was detected in gender,incidence of DM and hyperlipidemia,history of smoking,BMI,SD of nighttime SBP,SD of DBP,and SD of nighttime arterial pressure(P>0.05)while a significant difference was detected in age and incidence of hypertension among the different-score CSVD groups(P<0.01),and in SD of 24 h SBP,SD of day time SBP,SD of 24 h DBP,SD of daytime DBP,SD of 24 h arterial pressure,SD of daytime arterial pressure among the different-score CSVD groups(11.7±3.0 mm Hg vs 12.6±3.1 mm Hg vs 13.6±3.3 mm Hg vs 13.7±3.7 mm Hg vs 13.7±3.2 mm Hg,11.1±3.0 mm Hg vs 12.0±3.2 mm Hg vs 13.0±3.2 mm Hg vs 13.7±3.8 mm Hg vs 12.8±3.1 mm Hg,8.4±1.9 mm Hg vs 9.0±2.3 mm Hg vs 9.1±2.2 mm Hg vs 9.7±2.4 mm Hg vs 9.1±2.8 mm Hg,7.9±1.8 mm Hg vs 8.5±2.5 mm Hg vs 8.6±2.3 mm Hg vs 9.4±2.2 mm Hg vs 8.6±3.2 mm Hg,9.1±1.9 mm Hg vs 9.9±2.4 mm Hg vs 10.4±2.3 mm Hg vs 10.6±2.4 mm Hg vs 10.1±2.5 mm Hg,8.9±1.9 mm Hg vs 9.5±2.5 mm Hg vs 10.0±2.3 mm Hg vs 10.4±2.4 mm Hg vs 9.7±2.8 mm Hg,P<0.05,P<0.01).Logistic regression analysis showed that the SD of 24 h SBP was an independent risk factor for CSVD(P=0.032).Conclusion The 24 h BPV and daytime BPV are related with the severity of CSVD.
作者
范洋溢
程敏
高旭光
徐燕
Fan Yangyi;Cheng Min;Gao Xuguang;Xu Yan(Department of Neurology,Peking University People's Hospital,Beijing 100044,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2019年第9期914-917,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
高血压
大脑小血管疾病
卒中
认知障碍
步态失调
hypertension
cerebral small vessel diseases
stroke
cognition disorders
gait apraxia
