血压昼夜节律异常对不同亚型急性缺血性脑卒中影响的研究

Effect of abnormal blood pressure circadian rhythm on subtypes of acute ischemic stroke

目的探讨高血压患者血压昼夜节律异常对不同亚型急性缺血性脑卒中的影响。方法参照改良TOAST分型标准,将97例伴高血压的急性缺血性脑卒中患者分为动脉粥样硬化血栓形成(arterothrombosis,AT)组66例和小动脉病变(small artery disease,SAD)组31例,并进行24h动态血压监测。比较2组间24h、昼间和夜间的血压水平、晨峰血压及血压昼夜节律的变化。结果 AT组夜间收缩压明显高于SAD组[(133.86±18.17)mm Hg vs(124.42±16.06)mm Hg,1mm Hg=0.133kPa,P<0.05];AT组血压昼夜节律消失比例明显高于SAD组(84.8%vs 64.5%,P<0.05);2组晨峰血压发生率比较,差异无统计学意义(37.9%vs 19.4%,P>0.05)。结论血压昼夜节律消失和夜间血压水平升高与AT型缺血性脑卒中的发生有关。

Objective To study the effect of abnormal blood pressure （BP） circadian rhythm on subtypes of acute ischemic stroke （AIS） in hypertensive patients .Methods Ninety-seven AIS pa-tients with hypertension were divided into arterothrombosis （AT）group （n=66）and small artery disease （SAD）group （n=31）according to the modified TOAST classification .Their 24 h ambula-tory BP was monitored .The 24 h BP ,daytime and nighttime BP ,morning BP surge and BP circa-dian rhythm were compared between the two groups .Results The nighttime SBP was significant-ly higher in AT group than in SAD group （133 .86 ± 18 .17 mm Hg vs 124 .42 ± 16 .06 mm Hg , P〈0 .05） .The absent rate of BP circadian rhythm was higher in AT group than in SAD group （84 .8% vs 64 .5% ,P〈0 .05） .However ,no significant difference was found in morning BP surge between the two groups （37 .9% vs 19 .4% ,P〉0 .05） .Conclusion Absent BP circadian rhythm and elevated nighttime BP are related with AT type ischemic stroke .