高血压患者血压近日节律变化对腔隙性梗死的影响

The effect of circadian rhythm variation in blood pressure of patiets with hypertension disease on lacunar infarction

目的分析血压近日节律变化,了解高血压与腔隙性梗死的关系。方法收集高血压合并腔隙性梗死患者共119例,腔隙性梗死患者121例,高血压105例,正常对照组109例。分别进行连续24h血压监测。用余弦法分析4组血压的近日节律特征,采用t检验进行比较。结果 4组均存在近日节律,高血压患者的调整中值高于血压正常组,而振幅低于血压正常组;高血压合并腔隙性梗死组调整中值高于其他3组,而振幅低于其他3组;高血压组与腔隙性梗死组调整中值及振幅无统计学意义,但调整中值高于正常对照组,振幅低于正常对照组。结论血压近日节律的振幅降低是高血压及腔隙性梗死患者有别于健康人的特征,并且可能参与了腔隙性梗死发病。

Objective To analyze the effects of circadian rhythm variation in blood pressure of patients with hypertension on lacunar infarction. Methods Cases with hypertension accompanied with lacunar infarction group（n= 119）, lacunar infarction group（n= 121）, hypertensive group（n= 105） and control group（n= 109） were collected. Values of blood pressure were meas- ured by Ambulatory Blood Pressure Monitoring every 30 rain for 24 consecutive hours. After data of circadian rhythm in the four groups had been analyzed hy the cosine method,the parameters of circadian rhythm in the four groups were compared by t test. Results The four groups all had circadian rhythm. Midline-estimating statistic of rhythm（MESOR） in hypertension accompanied with lacunar infarction group was higher than that in the other three groups, and the amplitude of hypertension accompanied with lacunar infarction group was lower than that of the other three groups; MESOR and the amplitude of lacunar infarction group and hypertensive group had no difference, but MESOR of lacunar infarction group and hypertensive group were significantly higher and the amplitude were significantly lower than that in control group. Conclusion The diversification of circadian rhythm on blood pressure in hypertension with lacunar infarction is different with normal people, which might be in- volved in mechanism of lacunar infarction.