血压变异性与急性脑梗死病灶类型相关性研究

A CORRELATION STUDY ON BLOOD PRESSURE VARIABILITY AND THE TYPES OF ACUTE CEREBRAL INFARCTION

目的应用动态血压监测方法,观察急性期脑梗死患者血压的特点和血压波动情况,研究血压变异性(blood pressure variability,BPV)与脑梗死病灶类型的关系。方法选择唐山市协和医院神经内科住院治疗的236例急性脑梗死患者,入院后依据头颅CT或MRI将脑梗死分为单发组和多发组。同时选择同期非脑梗死者90例作为对照组。入院后3d内应用无创性动态血压监测仪进行血压监测,记录并通过软件分析后输出结果。结果 (1)急性脑梗死患者杓型节律比例低于非脑梗死组,全天平均收缩压(24hSBP)、日间平均收缩压(dSBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、全天平均脉压(24hPP)、日间脉压(dPP)、夜间脉压(nPP)、晨起收缩压(晨SBP)、晨起舒张压(晨DBP)、日间、夜间收缩压标准差(dSSD、nSSD)、日间舒张压标准差(dDSD)、收缩压标准差(nSSD)、收缩压晨峰(MBPS)高于非脑梗死组,差异有统计学意义(P<0.05)。(2)单发组杓型节律比例明显高于多发组,晨SBP、MBPS、dSSD、dDSD、nSSD低于多发组,差异有统计学意义(P<0.05)。结论脑梗死患者急性期收缩压、脉压较非脑梗死组显著增高,并伴有明显昼夜节律紊乱,血压变异增大。多发脑梗死组的血压变异性较单发组更大。

Objective To observe the blood pressure features and blood fluctuation in the patients with acute cerebral infarction by dynamic blood pressure monitoring,and to investigate the correlation of blood pressure variability（BPV）and lesion types of cerebral infarction.Methods Totally 236 patients hospitalized for acute cerebral infarction were screened from author＇s hospital.After hospitalization,they were divided into singlelesion group with 106 cases and multiple-lesion group with130 cases according to CT or MRI outcomes and Damasio＇s imaging system.And 90 cases with non-cerebral infarction diseases at same time period of hospitalization were recruited as control group.Blood pressure was monitored and recorded by noninvasive dynamic blood pressure monitor,and the outcomes were output through the software analysis 3 days after admittance.Results Patients with cerebral infarction showed a lower rate of dipper hypertensives than the non-cerebral infarction group.But the blood pressure of noninvasive dynamic blood pressure monitor were in higher levels than non-cerebral infarction group（P〈0.05）in 24 hSBP,dSBP,nSBP,nDBP,24 hPP,dPP,nPP,morning SBP,morning DBP,dSSD,dDSD,nSSD,MBPS and so on.Single-infarction group had higher rate of dipper hypertensives than the multiple-infarction group.But they were in lower levels in morning SBP,MBPS,dSSD,dDSD and nSSD than the multiple-infarction group（P〈0.05）.Conclusion In the acute phase,the systolic blood pressure,pulse pressure,morning peak blood pressure of cerebral infarction patients increased significantly.They are accompanied by circadian rhythm disorders and increased blood pressure variation.Multiple-infarction group has higher blood pressure variability than Single-infarction group.