动态血压与老老年高血压脑白质疏松患者认知功能的关系

Relationship between ambulatory blood pressure and cognitive function in elderly hypertensive patients with leukoaraiosis

目的比较老老年高血压患者不同程度脑白质疏松(leukoaraiosis,LA)的动态血压参数与认知功能的相关性。方法对80例老老年高血压患者行24h动态血压监测,观察24h收缩压变异性(systolic blood pressure variability,SBPV)、24h舒张压变异性(diastolic blood pressure variability,DBPV)、动态动脉硬化指数(ambulatory arterial stiffness index,AASI)、动态脉压指数(ambulatory pulse pressure index,APPI)等;并对患者行简易智能状态检查量表(MMSE)评估。结果与LA 0级比较,1级、2级、3级的24hSBPV、24hDBPV、AASI、APPI增大(P<0.05);与LA 1级比较,2级、3级24h-SBPV、24h-DBPV、AASI、APPI增大(P<0.05);LA 3级的24h-SBPV、AASI和APPI显著高于2级,差异有统计学意义(P<0.05)。与LA 0级、1级比较,2级、3级的记忆力、注意力和计算力、回忆能力、语言能力和总分显著降低,差异有统计学意义(P<0.05)。24hSBPV(r=-0.8697,P=0.000)、24hDBPV(r=-0.6709,P=0.002)、AASI(r=-0.8373,P=0.000)、APPI(r=-0.5991,P=0.007)与MMSE呈显著负相关。结论 LA程度越重,24hSBPV、AASI、APPI越大;24hSBPV、AASI可能作为LA、认知功能下降的预测指标。

Objective To analyze the relationship between ambulatory blood pressure（ABP）and cognitive function in elderly hypertensive patients with leukoaraiosis（LA）.Methods Eighty elderly hypertensive patients with LA underwent 24 hABP monitoring to record their 24 hSBPV,DBPV,AASI,and APPI.The patients were scored according to the MMSE Scale.Results The 24 h SBPV,DBPV,AASI,and APPI were significantly higher in degrees 1,2,3 of LA than in degree 0 of LA（P〈0.05）,in degrees 2,3 of LA than in degree 1of LA（P〈0.05）,and in degree 3 of LA than in degree 2 of LA（P〈0.05）.The MMSE Scale score of memory,attention,counting,recall,language and the total score were significantly lower in degrees 2,3 of LA than in degrees 1,2of LA（P〈0.05）.The 24 hSBPV,DBPV,AASI,and APPI were negatively related with the MMSE Scale score（r=-0.8697,P=0.000;r=-0.6709,P=0.002;r=-0.8373,P=0.000;r=-0.5991,P=0.007）.Conclusion The severer the LA is,the higher the 24 hSBPV,AASI and APPI are.The 24 hSBPV and AASI can thus be used as the indicators of LA and cognitive function impairement.