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帕金森病患者夜间高血压的临床特征及影响因素 被引量:1

Clinical characteristics and influencing factors of nocturnal hypertension in patients with Parkinson′s disease
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摘要 目的探讨帕金森病(PD)患者伴发夜间高血压(NH)的特点及相关影响因素。方法连续收集2017年1月至2020年1月于北京天坛医院住院的150例PD患者,对患者进行24h动态血压监测,按照是否伴有NH将PD患者分为两组:PD伴发NH(PD-NH)组和PD不伴发NH(PD-nNH)组。记录患者的人口学资料,采用帕金森病自主神经症状量表(SCOPA-AUT)评价患者的自主神经症状。记录入组患者全天、白天及夜间的收缩压标准差和相应时段的舒张压标准差。行超声心动图检查,记录患者的左心房内径、左室舒张末期内径、左室后壁厚度、舒张末期室间隔厚度及左室射血分数。采用SPSS 21.0软件进行数据分析。结果150例PD患者中,96例伴发NH。与PD-nNH组相比,PD-NH组患者合并高血压的患者多,SCOPA-AUT总分高(P<0.05)。PD-NH组全天收缩压标准差、晚间收缩压标准差及晚间舒张压标准差明显高于PD-nNH组患者(P<0.05)。PD-NH组患者舒张末期室间隔厚度、左室后壁厚度均明显大于PD-nNH组患者(P<0.05)。logistic回归分析结果显示晚间收缩压标准差(OR=1.160,95%CI 1.010~1.332,P=0.035)和舒张末期室间隔厚度(OR=1.589,95%CI 1.059~2.384,P=0.025)是PD-NH的独立影响因素。结论PD伴发NH的发生率高,晚间收缩压标准差增大、舒张末期室间隔厚度增高是PD-NH的独立影响因素。 Objective To explore the characteristics and influencing factors in patients with Parkinson′s disease(PD)complicated with nocturnal hypertension(NH).Methods From January 2017 to January 2020,a total of 150 PD patients admitted to Beijing Tiantan Hospital were consecutively recruited.The patients received 24-hour ambulatory blood pressure(BP)monitoring and were divided into PD with NH(PD-NH)group and PD with no NH(PD-nNH)group.The patient′s demographic data was recorded,and the scales for outcomes in Parkinson′s disease-autonomic(SCOPA-AUT)was used to evaluate the patient′s autonomic symptoms.The standard deviations of systolic BP and diastolic BP in the daytime,at night and during the whole day were collected.Echocardiography was performed,and data were recorded of the left atrium diameter,the left ventricular end-diastolic diameter,the left ventricular posterior wall thickness,end-diastolic interventricular septal thickness and left ventricular ejection fraction.SPSS statistics 21.0 was used for data analysis.Results Among 150 PD patients,96 were complicated with NH.Compared with the PD-nNH group,more patients had hypertension and higher SCOPA-AUT score in the PD-NH group(P<0.05).The standard deviations of all-day systolic BP,night-time systolic BP and night-time diastolic BP in the PD-NH group were significantly higher than those in the PD-nNH group(P<0.05).The end-diastolic interventricular septal thickness and the left ventricular posterior wall thickness in PD-NH group were significantly greater than those in PD-nNH group(P<0.05).Logistic regression analysis showed that the standard deviation of night-time systolic BP(OR=1.160,95%CI 1.010-1.332,P=0.035)and the end-diastolic interventricular septal thickness(OR=1.589,95%CI 1.059-2.384,P=0.025)were independent influencing factors of PD-NH.Conclusion The incidence of NH is high in PD patients.The increased standard deviation of systolic BP at night and the increase of end-diastolic interventricular septal thickness are independent influencing factors of
作者 李丽霞 刘丽 连腾宏 郭鹏 丁杜宇 李丹凝 张伟娇 关惠盈 张巍 LI Li-Xia;LIU Li;LIAN Teng-Hong;GUO Peng;DING Du-Yu;LI Dan-Ning;ZHANG Wei-Jiao;GUAN Hui-Ying;ZHANG Wei(Department of Internal Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijng 100070,China;Neurology Center,Beijing Tiantan Hospital,Capital Medical University,Beijng 100070,China;National Clinical Research Center for Neurological Diseases,Beijing 100070,China;Center of Parkinson′s Disease,Beijing Institute for Brain Disorders,Beijing 100053,China;Beijing Key Laboratory of Parkinson′s Disease,Beijing 100053,China)
出处 《中华老年多器官疾病杂志》 2021年第2期81-85,共5页 Chinese Journal of Multiple Organ Diseases in the Elderly
基金 国家重点研发计划项目(2016YFC1306000,2016YFC1306300) 国家重点研发计划-欧盟地平线2020计划合作项目(2017YFE0118800-779238) 国家自然科学基金面上项目(81970992,81571229,81071015,30770745) 北京市教育委员会科技发展计划重点项目(KZ201610025030) 北京市自然科学基金重点项目(4161004) 北京市自然科学基金面上项目(7082032) 北京市中医药科技发展资金项目(JJ2018-48) 首都临床特色应用研究项目(Z121107001012161)。
关键词 帕金森病 夜间高血压 血压变异性 舒张末期室间隔厚度 Parkinson′s disease nocturnal hypertension blood pressure variability end-diastolic interventricular septal thickness
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