血压变异性与脑梗死神经功能缺损程度的研究

Research of Blood Pressure Variability and Neurologic Impairment in Patients with 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,探讨血压变异性(blood pressure variability,BPV)与脑梗死神经功能缺损程度的关系。方法选择急性脑梗死患者236例,根据神经功能缺损程度评分将脑梗死分为轻度组、中度组和重度组。同时选择非脑梗死者90例作为对照组,入院后3天内进行血压监测。结果急性脑梗死患者杓型节律比例低于非脑梗死组,24h SBP、d SBP、n SBP、n DBP、24h PP、d PP、n PP、晨SBP、晨DBP、d SSD、d DSD、n SSD、MBPS高于非脑梗死组,差异有统计学意义(P<0.05)。重度组杓型节律者低于轻、中度组,中度组低于轻度组;晨SBP、MBPS、d SSD、d DSD、n SSD高于轻、中度组,中度组高于轻度组,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。血压变异性尤其收缩压变异增大与脑梗死神经功能损伤严重程度相关。

Objective To observe the blood pressure features and blood pressure in patients with acute stage cerebral infarction by dynamic blood pressure monitoring,to investigate the correlation of blood pressure variability（ BPV） with nerve function defect degree of cerebral infarction. Methods We selected 236 cases of patients with acute cerebral infarction. According to the scores to patients＇ verve function defect they were divided into mild group,moderate group,and severe group. At the same time,we chose 90 cases of the cerebral infarction as control group,within 3 days after admission for blood pressure monitoring. Results Patients with cerebral infarction had a lower rate of dipper hypertensives than the non-cerebral infarction group but higher levels of 24 h SBP,d SBP,n SBP,n DBP,24 h PP,d PP,n PP,morning SBP,morning DBP,d SSD,d DSD,n SSD,MBPS than non-cerebral infarction group（ P〈0.05）. The former was higher than the later in dipper hypertensives,but lower than the later in morning SBP,MBPS,d SSD,d DSD,n SSD（ P〈0.05）. Conclusion In the acute phase,the systolic blood pressure,pulse pressure,morning peak blood pressure of cerebral infarction patients increased significantly,the increase of systolic blood pressure was associated with a significant degree of impairment of the cerebral infarction.