不同血压类型脑梗死患者动态血压参数与动脉硬化指数关系的研究

Relation between ambulatory BP parameters and arteriosclerosis index in cerebral infarction patients with different types of BP

目的探讨不同血压类型脑梗死患者动态血压参数与动脉硬化指数的关系。方法选择住我院卒中单元病房治疗的265例急性缺血性脑卒中患者,将入选患者分为杓型组80例、非杓型组90例和反杓型组95例。应用美国国立卫生研究院卒中量表评分和Barthel指数评分,对各组入院时和随访3个月的患者行神经功能缺损程度和日常生活能力评估,并评价各组患者改善率、复发率和病死率的差异。结果 3组患者动态血压参数、动态动脉硬化指数(AASI)比较,差异有统计学意叉(P<0.05),反杓型组AASI高于杓型组和非杓型组(P<0.05),脑梗死患者部分动态血压参数与AASI呈正相关(P<0.05),AASI与高敏C反应蛋白呈正相关。随访3个月,反杓型组的改善率低,而病死率高于杓型组和非杓型组(P<0.05)。结论不同血压类型患者AASI不同,反杓型高血压患者动脉粥样硬化病变明显,预后不良。

Objective To study the relation between ambulatory blood pressure（ABP）parameters and ambulatory arteriosclerosis index（AASI） in cerebral infarction patients with different types of BP. Methods Two hundred and sixty-five patients with acute cerebral ischemic infarction admit- ted to our hospital were divided into dipper BP group（n = 80）, non-dipper BP group （n=90） and anti-dipper BP group（n= 95）. Their neurological function and daily living ability were assessed at admission and during the 3-month follow-up period according to the NIHSS and the Barthel in- dex,respectively. Difference in their symptom improvement, recurrence and mortality was detec- ted. Results The ABP parameters and AASI were significantly different in 3 groups（P〈0.05）. The AASI was significantly higher in anti-dipper BP group than in dipper BP group and non-dip- per BP group（P〈0.05）. Certain ABP parameters were positively related with the AASI while the AASI was positively related with the high sensitivity C-reactive protein（P〈0.05）. The symptom improvement rate was lower while the mortality was higher in anti-dipper BP group than in dipper BP group and non-dipper BP group（P〈0.05） after 3-month follow-up（P〈0.05）. Conclusion AASI is different in patients with different types of BP. Atherosclerosis is severe in patients with anti-dipper BP. The prognosis of such patients is poor.