广州社区缺血性脑血管病的血压变异性及常见危险因素分析

Blood pressure variability and common risk factors of ischemic cerebrovascular disease in Guangzhou communities

目的分析广州社区缺血性脑血管病的血压变异性及常见危险因素。方法收集2016年7月至2017年12月入住本院的广州社区缺血性脑血管病(ICD)患者326例,和对照组113例相比较,分析两组间入院当时及入院后前两天早晨的平均收缩压(SBP)和舒张压(DBP),血压变异性(SBPV、DBPV)及其他如血脂等危险因素;然后再将ICD患者分为急性脑血栓形成(ACT)237例和短暂性脑缺血发作(TIA)89例两个亚组,分析两者之间参数的差异。结果ICD组的SBPV(Z=4.662,P<0.01)、SBP(t=8.092,P<0.01)和DBP(t=6.653,P<0.01)均高于对照组。logistic回归发现ICD的发病主要与SBPV(OR=342497.33,P=0.000)、SBP(OR=1.035,P=0.000)、DBP(OR=1.040,P=0.004)有关。另外,与TIA组比较,ACT组SBPV(Z=-2.013,P<0.05)、SBP(Z=-4.695,P<0.05)、DBP(Z=-4.486,P<0.05)均增高;而且ACT发病亦与SBPV(OR=2186.769,P=0.032)、SBP(OR=1.025,P=0.011)和DBP(OR=1.039,P=0.016)相关。结论SBPV、平均SBP和DBP是ICD与ACT发病的危险因素;其中,SBPV危险性最大,它可能在ACT发病过程中起关键作用。

Objective To analyze the blood pressure variability (BPV) and common risk factors of ischemic cerebrovascular disease (ICD) in Guangzhou communities. Methods From July, 2016 to December, 2017, 326 ICD inpatients from Guangzhou communities were collected, and compared with 113 patients in a control group. The risk factors between the ICD group and the control group were analyzed with the respects to the average systolic blood pressure (SBP), diastolic blood pressure (DBP), BPV (including SBPV and DBPV on admission and in the first two mornings after admission as well as and other factors such as blood lipid, etc. Afterwards, the ICD group was further divided into a acute cerebral thrombosis (ACT) group and a transient ischemic attack (TIA) group to further compare the parameter differences between them. Results The SBPV (Z =4.662, P< 0.01), SBP (t =8.092, P< 0.01), DBP(t =6.653, P< 0.01) in the ICD group were higher than those in the control group. Logistic regression revealed that the onset of ICD was related to SBPV (OR = 342 497.33, P= 0.000), SBP (OR = 1.035,P = 0.000), and DBP (OR =1.040, P = 0.004). Additionally, compared to the TIA patients, the SBPV (Z =-2.013, P< 0.05), SBP (Z =-4.695, P< 0.05), and DBP (Z =-4.486, P< 0.05) of the ICD patients all raised. Moreover, the onset of ACT was as well related to SBPV (OR = 2 186.769, P = 0.032), SBP (OR = 1.025, P = 0.011), and DBP (OR =1.039, P = 0.016). Conclusions SBPV, Mean SBP, and DBP are risk factors not only for the onset of ICD, but also for ACT;and among them, SBPV is the most dangerous, and it may play an important role in the development of ACT.