喀什地区原发性高血压患者血压变异性与无症状性脑梗死的关系

Relationship between blood pressure variability and asymptomatic cerebral infarction in patients with hypertension in Kashgar

目的探讨喀什地区原发性高血压(高血压)患者24 h的血压变异性是否与无症状性脑梗死[又称静止性脑梗死(silent cerebral infarct,SCI)]的发病具有相关性。方法 272例高血压合并SCI患者为观察组,142例单纯高血压患者为对照组,对两组进行24 h动态血压监测,计算夜间血压下降率,并比较两组在年龄、血脂、血糖、肾功能、头颅计算机断层扫描或核磁共振成像结果。结果两组年龄和血清胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、血糖、尿素、肌酐浓度比较,差异无统计学意义(P>0.05)。而在夜间血压下降率方面,对照组夜间血压下降率明显高于观察组,差异有统计学意义(P<0.05)。与对照组相比,观察组的血压变异性昼夜模式的差异有统计学意义(P<0.05)。结论非杓型高血压与SCI的发生可能有一定关系。异常的血压昼夜节律可能是评估脑血管损害的参数,是SCI的一个危险相关因素。

Objectives To explore the relationship between 24-hour blood pressure variability and pathogenesis of silent cerebral infarct（SCI） in hypertensive patients in Kashgar. Methods A total of 272 cases with hypertension and SCI were enrolled in observation group, and 142 cases with hypertension were enrolled in control group. The 24-hour ambulatory blood pressure was monitored and the night rate of blood pressure reduction was measured. The age, blood lipids, blood glucose, renal function, computerized tomography image（CT） and magnetic resonance image（MRI）were compared between the two groups. Results The age and serum concentrations of total cholesterol, triglyceride,high-density lipoprotein, low-density lipoprotein, blood sugar, urea and creatinine were not statistically different between the two groups（P〉0.05）. The night rate of blood pressure reduction in control group was higher compared with that in observation group, and the difference was significant（P〈0.05）. Compared with control group, the difference was significant in day and night modes of blood pressure variability in observation group（P〈0.05）. Conclusions Non-dipper hypertension is associated with the occurrence of SCI. The abnormal rhythm of blood pressure may be a parameter for assessing cerebrovascular damage, which is a risk factor of SCI.