摘要
目的探讨短时血压变异性与缺血性脑卒中患者脑微出血灶的相关性。方法入组74例急性缺血性脑卒中患者,所有患者完成24 h动态血压监测,评估血压变异性的指标包括日间收缩压最大值(DSBP-Max)、日间舒张压最大值(DDBP-Max);夜间收缩压最大值(NSBP-Max)、夜间舒张压最大值(NDBP-Max);日间收缩压标准差(DSBP-SD)、日间舒张压标准差(DDBP-SD);日间收缩压变异系数(DSBP-CV)、日间舒张压变异系数(DDBP-CV);夜间收缩压标准差(NSBP-SD)、夜间舒张压标准差(NDBP-SD);夜间收缩压变异系数(NSBP-CV)、夜间舒张压变异系数(NDBP-CV)。采用MARS评分法评估脑微出血病变。统计学分析血压变异性与脑微出血病变的相关性。结果深部微出血组DSBP-Max、DDBP-Max、NDBP-Max均显著高于无深部微出血组(依次为P=0.045、P=0.002、P=0.012);幕下微出血组DDBP-SD、DDBP-CV均显著高于无幕下微出血组(依次为P=0.006、P=0.005);脑叶微出血组与无脑叶微出血组血压峰值及血压变异性无显著性差异。多因素分析显示,深部微出血与DDBP-Max独立相关(OR=1.079,95%CI:1.030~1.131,P=0.002);幕下微出血与DDBP-CV独立相关(OR=1.486,95%CI:1.105~1.998,P=0.009)。结论本研究结果显示短时血压变异性与深部及幕下微出血具有相关性,临床上我们在关注降压药物降压水平的同时,需要关注血压变异性。
Objective To assess the association between the short-term blood pressure variability (BPV) and cerebral microbleeds. Methods 74 patients with acute ischemic stroke were enrolled.The 24 h ambulatory blood pressure monitoring was used to measure the blood pressure.BPV parameters included day systolic blood pressure-maximum (DSBP-Max),day systolic blood pressure-maximum(DDBP-Max),night systolic blood pressure-maximum (NSBP-Max),night diastolic blood pressure-maximum (NDBP-Max),day systolic blood pressure-standard deviation (DSBP-SD),day systolic blood pressure-standard deviation (DDBP-SD),day diastolic blood pressure-coefficient of variation (DSBP-CV),day systolic blood pressure-coefficient of variation (DDBP-CV),night systolic blood pressure-standar deviation (NSBP-SD),night diastolic blood pressure-standard deviation (NDBP-SD),night systolic blood pressure-coefficient of variation (NSBP-CV),and night diastolic blood pressure-coefficient of variation (NDBP-CV).Cerebral microbleeds were assessed using Microbleed Anatomical Rating Scale (MARS).Multiple logistic regression was used to assess the association between BPV parameters and cerebral microbleeds. Results Patients with microbleeds in deep region had significant higher DSBP-Max,DDBP-Max and NDBP-Max than patients without microbleeds in deep region ( P 〈0.05).Patients with infratentorial region microbleeds had significant higher DDBP-SD and DDBP-CV than patients without infratentorial region microbleeds ( P 〈0.05).Logistic regression analysis indicated that DDBP-Max was the independent risk factor for microbleeds in deep regio ( OR = 1.079,95% CI :1.030~1.131, P =0.002),and DDBP-CV was the independent risk factor for infratentorial region microbleeds ( OR =1.486,95% CI :1.105~1.998, P =0.009). Conclusion This study indicated that short-term BPV was associated with cerebral microbleeds in deep and infratentorial region.We should pay attention to BPV besides blood pressure level.
作者
孙丽丽
冯羿博
焦劲松
刘玮
乔亚男
卢烁
叶伟杰
田敏
刘尊敬
SUN Lili;FENG Yibo;JIAO Jinsong(Department of Neurology,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中风与神经疾病杂志》
CAS
2018年第6期484-487,共4页
Journal of Apoplexy and Nervous Diseases
基金
中日友好医院青年科技英才计划(No.2014-QNYC-A-04)
中日友好医院院级课题(No.2015-2-QN-36)
关键词
血压变异性
脑微出血
脑卒中
Blood pressure variability; Microbleeds; Stroke