不同病因型缺血性脑卒中患者的血压变异性

Blood pressure variability among different subtypes of acute ischemic stroke

目的探讨急性缺血性脑卒中患者的血压变异性。方法选择2009-07-2011-07乌鲁木齐市友谊医院神经内科、急诊科急性缺血性脑卒中患者226例[男128例,女98例,年龄(66.2±11.9)岁]。按"类肝素药物治疗急性缺血性脑卒中试验"分型分为动脉粥样硬化血栓形成(AT)组98例、心源性脑栓死(CE)组39例、小动脉病变(SAD)组89例;选择同期健康对照组226例,男性140例,女性86例,年龄(65.6±10.8)岁。24h动态血压仪监测血压和血压变异性。结果与对照组比较,AT、CE、SAD组24h平均收缩压[(136.7±11.7)、(131.2±12.5)、(138.1±15.3)比(116.7±13.2)mmHg]、24h平均舒张压[(77.9±12.5)、(70.2±11.4)、(77.2±12.7)比(64.4±11.5)mmHg]、脉压指数[(0.46±0.08)、(0.42±0.07)、(0.45±0.05)比(0.37±0.07)]、24h舒张压变异系数(24hDBPV)[(0.17±0.05)、(0.14±0.02)、(0.17±0.01)比(0.11±0.04)]均较高。AT、CE、SAD组血压昼夜节律频率分布比较,差异有统计学意义(P<0.05)。结论急性缺血性脑卒中患者的血压变异性明显增大,不同病因型缺血性脑卒中患者的血压变异性不同。

Objective To explore the blood pressure variability among different subtypes of acute ischemic stroke. Methods From July 2009 to July 2011, two hundred and twenty six acute ischemic stroke patients aged （ 66.2 ± 11.9） years, including 128 males and 98 females, were selected in the department of Neurology and emergency of Urumqi friendship hospital. Based on the criteria and classification of ＂trial of Org 10 172 in acute stroke treat ment＂, these patients were divided into three groups： arterial therothrombosis （AT） group （n=98）, cardioembo lism （CE） group（n=39）, and small artery disease {SAD） group（n=89）. And another 226 physically healthy sub jects at the age of （65.6±10.8） years, including 140 males and 86 females, were selected as controls. Their levels and variability of blood pressure were investigated by 24-hour ambulatory monitor. Results In AT, CE and SAD group, the 24-hour mean systolic blood pressure [（136.7±11.7）, （131.2±12.5）, （138.1±15.3） vs （116.7±13.2） mm Hg], 24 hour mean diastolic blood pressure [（77.9±12.5）, （70.24±11.4）, （77.2±12.7） vs （64.4±11.5） mm Hg], pulse pressure index[（0. 46±0.08）, （0. 42±0.07）, （0. 45±0.05） vs （0. 37±0.07）] and variabil ity of 24-hour diastolic blood pressure [（0.17±0.05）, （0.14±0.02）, （0.17±0.01） vs （0. 11±0.04）] were higher than those in the control group. There were statistical differences in the distribution of blood pressure circadian rhythms between three groups（P〈0.05）. Conclusions The blood pressure variability of acute ischemic stroke pa tients is obviously higher than that of the healthy population. There are statistical differences in blood pressure var iability of different ischemic stroke subtypes.