中心动脉压与外周桡动脉压的差异对腔隙性脑梗死患者的影响

Effects of the difference between peripheral arterial and central arterial blood pressures on patients with cerebral lacunar infarction

目的测量腔隙性脑梗死患者的外周与中心动脉压力，观察中心动脉压与外周桡动脉压的差异对腔隙性脑梗死的影响。方法收集我院231例进行冠状动脉造影的患者，根据入院时CT或MRI分为腔隙性脑梗死组129例和无腔隙性脑梗死组122例。冠状动脉造影结束后，采用造影导管测量升主动脉根部及外周桡动脉内血压，比较2组患者主动脉根部及外周桡动脉内收缩压（SBP）、舒张压（DBP）和脉压差（PP），采用t检验进行比较。结果2组患者基线血压、血脂、血糖、年龄及性别等差异无统计学意义（P〉0．05）；腔隙性脑梗死组患者中心动脉与外周桡动脉SBP差值[（7．6±2．3）mmHg（1mmHg=0．133kPa）比（23．6±5．7）mmHg]、中心动脉与外周桡动脉内平均动脉压（MAP）差值[（6．6±2．1）mmHg比（20．1±6．2））mmHg]及中心动脉与外周桡动脉内PP差值[（5．8±1．7）mmHg比（12．9±5．3）mmHg]明显小于无腔隙性脑梗死组患者，中心动脉SBP[（125．5±10．4）mmHg比（112．6±11．4）mmHg]、MAP[（100．6±8．8）mmHg比（89．5±8．1）mmHg]和PP[（46．2±7．5）mmHg比（35．1±5．6）mmHg]均高于无腔隙性脑梗死组患者，差异有统计学意义（P〈0．05）；而外周桡动脉SBP[（132．8±13．1）mmHg比（134．9±12．5）mmHg]、外周桡动脉MAP[（107．8±10．1）mmHg比（111．2±9．4）mmHg]、外周桡动脉PP[（51．7±6．9）mmHg比（49．7±6．2）mmHg]、外周桡动脉DBP[（84．2±9．3）mmHg比（82．1±8．6）mmHg]、中心动脉DBP[（80．7±7．5）mmHg比（76．7±7．2）mmHg]以及外周桡动脉DBP与中心动脉DBP差值[（3．7±0．9）mmHg比（4．3±1．4）mmHg]，两组患者比较差异无统计学意义（P〉0．05）。结论腔隙性脑梗死的发生可能与主动脉根部及外周桡动脉内SBP、MAP和PP降低有关。【Abstract】ob．iectiveToanalyzetheeffectsofthedifferencebetweentheperipheralarterialandthecentralarterialbloodpressuresoncerebrallacunarinfarction．MethodsThecerebrallacunarinfarctiongroup（n=129）andcontrolgroup（n：122）weresetup．Thesystolicbloodpressure（SBP）anddias—tolicbloodpressure（DBP）oftheascendingaortaandradialarteryweresimultaneouslyrecordedpostopera—tivelv．andmeanarterypressure（MAP）andpulsepressure（PP）werecalculated．ResultsTherewasnosignificantdifferencebetweencerebrallacunarinfarctiongroupandcontrolgroupinbasicbloodpressure．bloodliplid．bloodglucose．heartrate，ageandsex（allP〉0．05）．ThediffereneeofSBP[（7．6±2．3）mmHg（1mmHg=0．133kPa）VS．（23．6±5．7）mmHg]，MAP[（6．6-4-2．1）mmHgVS．（20．1±6．2）mmHg]andPP[（5．8±1．7）mmHgVS．（12．9±5．3）mmHg]betweentheperipheralandaorticpressuresincerebrallacunarinfarctiongroupwashigherthanincontrolgroup（P〈0．05），buttherewasnosignificantdifierenceinSBP『（132．8±13．1）mmHgVS．（134．9±12．5）mmHgJ，MAP『（107．8±10．1）mmHgVS．（111．2±9．4）mmHg]，PP[（51．7±6．9）mmHgVS．（49．7-4-6．2）mmHgj，andDBP『（84．2-4-9．3）mmHgVS．（82．1±8．6）mmHgii3radialarterybetweenthetwogroups（a11P〉0．05）．andtherewasnosignifican!differenceinDBP[（80．7±7．5）mmHgVS．（76．7±7．2）mmHg]intheascendingaortaandthedifferenceofDBPbetweentheperipheralandaorticpressuresbetweenthetwo^roups．too（allP〉0．05）．ConclusionThedifferenceofSBP，MAPandPPbetweentheperipheralarterialandthecentralarterialbloodoressureswascorrelatedwithcerebrallacunarinfarction．

Objective To analyze the effects of the difference between the peripheral arterial and the central arterial blood pressures on cerebral lacunar infarction. Methods The cerebral lacunar infarction group （n = 129） and control group （n = 122） were set up. The systolic blood pressure （SBP） and diastolic blood pressure （DBP） of the ascending aorta and radial artery were simultaneously recorded postoperatively, and mean artery pressure （MAP） and pulse pressure （PP） were calculated. Results There was no significant difference between cerebral lacunar infarction group and control group in basic blood pressure, blood lipid, blood glucose, heart rate, age and sex （ all P 〉 0. 05 ）. The difference of SBP [ （ 7.6 ± 2.3） mmHg（1 mmHg=0. 133 kPa） vs. （23.6 ± 5.7） mmHg], MAP [（6.6 ± 2.1） mmHg vs. （20.1 ±6.2） mmHg] andPP [（5.8 ±1.7） mmHg vs. （12.9±5.3） mmHg] between the peripheral and aortic pressures in cerebral lacunar infarction group was higher than in control group （ P 〈 0. 05 ） , but there was no significant difference in SBP [ （ 132. 8 ± 13.1 ） mmHg vs. （ 134. 9 ± 12. 5） mmHg] , MAP [ （ 107. 8 ± 10. 1 ） mmag vs. （ 111.2 ± 9.4） mmHg], PP [ （51.7 ± 6. 9） mmHg vs. （49.7 ± 6. 2） mmHg ], and DBP [ （ 84. 2 ± 9. 3 ） mmHg vs. （ 82. 1 ± 8.6 ） mmHg ] in radial artery between the two groups （ all P 〉0. 05）, and there was no significant difference in DBP [ （80. 7 ± 7. 5） mmHg vs. （76. 7 ±7. 2） mmHg] in the ascending aorta and the difference of DBP between the peripheral and aortic pressures between the two groups, too （ all P 〉 0. 05 ）. Conclusion The difference of SBP, MAP and PP between the peripheral arterial and the central arterial blood pressures was correlated with cerebral lacunar infarction.