摘要
目的探讨中老年高血压患者血压昼夜节律波动类型与脑微出血(CMB)的关系。方法选取有高血压病的中老年患者,通过24 h动态血压仪监测血压及颅脑磁敏感加权成像(SWI)序列检测脑微出血,对年龄分组后,比较脑微出血患者的危险因素,并通过Logistic回归分析不同血压昼夜节律波动类型和CMB、CMB发生位置的关系。结果在中年高血压患者中,34%的患者可见CMB,血压昼夜波动类型和CMB的发生差异无统计学意义(P>0.05);在老年高血压患者中,52%的患者存在CMB,经多因素分析后发现血压昼夜节律波动类型和CMB的发生有关,并且非杓型高血压患者比杓型高血压患者发生脑微出血的风险更大(OR=3.959,P=0.032),进一步对CMB的发生部位进行分析,发现和杓型高血压相比,非杓型高血压和深部CMB的发生有关(OR=6.201,P=0.007)。结论血压昼夜节律异常可能是老年高血压患者发生CMB的危险因素。
Objective To discuss the relationship between circadian rhythm of blood pressure and cerebral microbleed(CMB)in middle-aged and elderly hypertensive patients.Methods The CMB data of the middle aged and elderly subjects with both hypertension and monitored blood pressure were detected by 24-hour ambulatory blood pressure monitoring(ABPM)and assessed by susceptibilit weighted imaging(SWI).The risk factors were compared between CMB(+)vs.(-)groups after grouping based on the age,then the correlation between blood pressure circadian rhythm and CMB as well as the location of CMB were analyzed by logistic regression.Results 34%of the subjects with hypertension had CMB and the circadian rhythm of blood pressure associated with the presence of CMB had no statistical significance in middle-aged hypertensive subjects(P>0.05).There were 52%subjects with hypertension had CMB,and blood pressure circadian rhythm were associated with the occurrence of CMB on multiple factors analysis in elderly subjects with hypertension,and the non-dipper hypertensive subjects with CMB(OR=3.959,P=0.032)had higher risk than the dipper hypertensive subjects.According to the location of CMB,blood pressure circadian rhythm was associated with the occurrence of deep CMB on multiple factors analysis,and the non-dipper hypertensive subjects with deep CMB(OR=6.201,P=0.007)was higher risk than dipper hypertensive subjects.Conclusion The circadian rhythm type of blood pressure may be the risk factor of the occurrence of CMB.
作者
邓秀梅
毛诗贤
冯占辉
吴珊
胡乐乐
彭俊
DENG Xiumei;MAO Shixian;FENG Zhanhui(Comprehensive Ward(Department of Geriatrics),the Affiliated Hospital of Guizhou Medical University,Guiyang(550004),Guizhou China)
出处
《癫痫与神经电生理学杂志》
2021年第5期294-299,共6页
Journal of Epileptology and Electroneurophysiology(China)
基金
贵阳市白云区科技计划项目[白科合同(2019)37号]
国家重点研发计划基金项目(NO:2018YFCl312901)。
关键词
脑微出血(CMB)
血压昼夜节律
高血压病
磁敏感加权成像
动态血压
cerebral microbleed(CMB)
blood pressure circadian rhythm
hypertension
susceptibility weighted imaging
ambulatory blood pressure monitoring