短期和长期血压变异性对腔隙性脑梗死患者再次卒中风险的影响

Effects of short-term and long-term blood pressure variability on the risk of recurrent stroke in patients with lacunar infarction

目的探讨短期和长期血压变异性(BPV)对腔隙性脑梗死(LI)患者再次卒中风险的影响。方法选取2017年3月至2018年6月宁波大学医学院附属医院脑血管科收治的LI患者378例,随访1年,根据再次卒中发生与否分为卒中组34例和对照组324例。比较两组患者一般资料、相关血液学指标、短期和长期BPV水平,采用logistic回归分析LI患者再次卒中的独立危险因素。结果378例LI患者,失访20例,发生再次卒中34例,再次卒中发生率为8.99%。两组患者年龄、糖尿病病史、高血压病史、FPG、动态血压监测标准差(ABPM-sd)、动态血压监测变异系数(ABPM-CV)、家庭血压测量标准差(HBPM-sd)和家庭血压测量变异系数(HBPM-CV)比较差异均有统计学意义(均P<0.05)。logistic回归分析结果显示年龄、FPG、ABPM-CV、HBPM-sd和HBPM-CV均是LI患者再次卒中的独立危险因素(均P<0.05)。结论相对于短期BPV,长期BPV与LI患者发生再次卒中的关系更为密切。

Objective To investigate the effects of short-term and long-term blood pressure variability(BPV)on the risk of recurrent stroke in patients with lacunar infarction.Methods A total of 378 patients with lacunar infarction admitted in Affiliated Hospital of Ningbo University School of Medicine from March 2017 to June 2018 were enrolled.Patients were followed up for 1 year,The recurrent stroke occurred in 34 patients(8.99%,stroke group),and the rest 324 patients served as control group.The general data,blood glucose,blood lipids,short-term and long-term BPV levels were compared between the two groups.Logistic regression was used to analyze risk factors for recurrent stroke in patients with lacunar infarction.Results The age,history of hypertension and diabetes,FPG,ambulatory blood pressure standard deviation(ABPM-sd),and ambulatory blood pressure coefficient of variation(ABPM-CV),family blood pressure standard deviation(HBPM-sd)and family blood pressure coefficient of variation(HBPM-CV)were significantly associated with the recurrent stroke(all P<0.05).Logistic regression analysis showed age,FPG,ABPM-CV,HBPM-sd,HBPM-CV were the risk factors for recurrent stroke in patients with lacunar infarction(all P<0.05).Conclusion Compared to short-term BPV,long-term BPV is more closely correlated with recurrent stroke in patients with lacunar infarction.