急性脑梗死患者颈动脉狭窄及程度与血压变异性的研究

Research between carotid artery stenosis and its degree and blood pressure variability in patients with acute cerebral infarction

目的探讨急性脑梗死患者颈动脉狭窄及程度与血压变异性的关系。方法 236例急性脑梗死患者应用超声检测颈动脉,据超声检查结果分为狭窄组和非狭窄组,据狭窄程度分为≥50%组和<50%组,并进行动态血压监测,分析血压变异性与颈动脉狭窄及程度的关系。结果①狭窄组日间收缩压标准差(dSSD)[(12.87±4.15)mm Hg,1mm Hg=0.133 kPa]、日间舒张压标准差(dDSD)[(10.65±3.10)mm Hg]、夜间收缩压标准差(nSSD)[(11.49±4.91)mm Hg]高于非狭窄组[(10.91±3.51)、(8.69±2.83)、(9.53±4.61)mm Hg](t=2.460,P=0.015;t=3.264,P=0.001;t=2.068,P=0.040),杓型节律者比例(18.9%)低于非狭窄组(40.0%),差异有统计学意义(χ2=11.573,P=0.009)。②狭窄程度≥50%组dSSD[(14.23±4.35)mm Hg]、dDSD[(11.29±3.20)mm Hg]、nSSD[(12.60±5.06)mm Hg]高于狭窄程度<50%组[(11.74±3.90)、(9.87±3.12)、(10.59±4.91)mm Hg](t=4.081,P=0.000;t=2.993,P=0.003;t=2.695,P=0.008),杓型节律者比例(28.1%)低于狭窄程度<50%组(40.1%),差异有统计学意义(χ2=8.252,P=0.041)。结论血压变异性与颈动脉狭窄发生率和程度有关,血压变异大者易出现颈动脉狭窄并且程度较重。

Objective To discuss the relationship between carotid artery stenosis and its degree and blood pressure variability in patients with acute cerebral infarction. Methods Carotid artery was detected byh ultrasonic in 236 cases of patients with acute cerebral infarction. According to ultrasound results they were divided into the stenosis group and non-stenosis group, According to the stenosis degree, patients were divided into the stenosis degree ≥ 50% group and stenosis degree 〈50% group. Ambulatory blood pressure was monitored, then the relationship between carotid artery stenosis and its degree and blood pressure variability were analyzed. Results ①The daytime systolic standard deviation （dSSD） [（12.87±4.15）mm Hg, 1 mm Hg=0.133 kPa], the daytime diastolic blood pressure standard deviation （dDSD） [（10.65±3.10） mm Hg] and the night systolie blood pressure standard deviation （nSSD） [（11.49±4.91） mm Hg]in the stenosis group were all significantly higher than those in the non-stenosis group [（10.91±3.51）, （8.69±2.83）, （9.53±4.61） mm Hg] （t=2.460, P = 0.015; t = 3.264, P = 0.001; t = 2.068, P = 0.040）, while the proportion of dipper rhythm in the stenosis group （18.9%） was lower than that in the non-stenosis group （40.0%）, the differences was significant （χ^2=11.573, P = 0.009）. ②dSSD [（14.23±4：35） mm Hg], dDSD [（11.29±3.20） ram Hg] and nSSD [（12.60±5.06）mm Hg] in the stenosis degree t〉 50% group were all significantly higher than those in the stenosis degree 〈50% group [（11.74±3.90）, （9.87±3.12） （10.59±4.91） mm Hg] （t = 4.081, P = 0.000; t = 2.993, P = 0.003; t = 2.695, P = 0.008）,while the proportion of dipper rhythm in the stenosis degree ≥ 50% group （28.1%） was lower than that in the stenosis degree 〈50% group（40.1%）, the difference was significant （X^2=8.252, P=0.041）. Conclusion Blood pressure variability has relate to carotid artery stenosis and its degree, blood pressure variability greater prone to carotid stenosis and more severe.