原发性高血压合并脑微出血患者血压水平及危险因素分析

Analysis of blood pressure level and risk factors in patients with essen-tial hypertension and cerebral micro hemorrhage

目的探讨原发性高血压合并脑微出血患者血压水平及危险因素。方法选取2016年2月—2019年6月在榆林市第一医院治疗的原发性高血压患者218例,其中合并脑微出血患者88例(观察组),无脑微出血患者130例(对照组),检测两组24 h动态血压等,比较两组临床资料。结果观察组昼间收缩压(dSBP)、夜间收缩压(nSBP)和夜间舒张压(nDBP)分别为(160.06±17.81)mmHg(1 mmHg=0.133 kPa)、(156.66±18.12)mmHg和(86.64±9.90)mmHg,明显高于对照组(P<0.05),而SBP和DBP夜间下降率分别为(2.12±0.64)%和(1.66±0.55)%,明显低于对照组(P<0.05);观察组吸烟、心血管危险分层高危及极高危比例分别为48.86%和72.73%,明显高于对照组(P<0.05);Logistic回归分析结果显示:吸烟、心血管危险分层、SBP夜间下降率、DBP夜间下降率是原发性高血压患者发生脑微出血的影响因素(OR=3.747、4.730、0.429和0.401,P<0.05)。结论SBP和DBP夜间下降率、吸烟及心血管危险分层是原发性高血压患者发生脑微出血的影响因素,临床治疗时应加以重视。

Objective To explore the blood pressure level and risk factors of patients with primary hypertension and ce⁃rebral micro hemorrhage.Methods From February 2016 to June 2019,218 patients with essential hypertension were selected and treated in our hospital,including 88 patients with cerebral micro hemorrhage(observation group),130 pa⁃tients without cerebral micro hemorrhage(control group),the 24-hour ambulatory blood pressure and so on was mea⁃sured in the two groups,and the clinical data of the two groups were compared.Results The daytime systolic blood pressure(dSBP),nighttime systolic blood pressure(nSBP)and daytime diastolic blood pressure(nDBP)in the observa⁃tion group were(160.06±17.81)mmHg,(156.66±18.12)mmHg and(86.64±9.90)mmHg,which were significantly high⁃er than those in the control group(P<0.05),while the nighttime decrease rates of SBP and DBP were(2.12±0.64)%and(1.66±0.55)%,which were significantly lower than those in the control group(P<0.05).The proportion of smoking,high risk and very high risk in cardiovascular risk stratification in the observation group were 48.86%and 72.73%,respec⁃tively,which was significantly higher than that in the control group(P<0.05).The results of logistic regression analysis showed that smoking,cardiovascular risk stratification,SBP night drop rate and DBP night drop rate were the influenc⁃ing factors(OR=3.747,4.730,0.429 and 0.401,P<0.05).Conclusion The rate of SBP and DBP decrease at night,smoking and cardiovascular risk stratification are the influencing factors of cerebral micro hemorrhage in patients with essential hypertension,the clinical treatment history should be paid attention.