高血压患者脑血管功能积分与动态血压参数特点相关性研究

The correlation between cerebrovascular function scores and ambulatory blood pressure parameters in patients with primary hypertension

目的观察高血压患者脑血管功能积分与24 h动态血压参数特征,探讨高血压患者脑卒中风险的影响因素。方法选取2016年1月至2017年11月在重庆市人民医院健康管理(体检)中心进行体检的328例患者进行分析,根据脑血管积分值分为非高危组(≥75分)和高危组(<75分),比较两组患者动态血压参数差异,分析其与脑血管功能积分异常的相关性。结果高血压患者平均脑血管功能积分为(84.48±16.48)分,异常率26.83%。非高危组脑血管功能积分(93.02±7.02)分,高危组脑血管功能积分为(61.18±11.50)分,差异有统计学意义(t=15.151,P<0.01)。高危组24 h收缩压、24 h舒张压、白天收缩压、白天舒张压、夜间收缩压、夜间舒张压、白天收缩压变异系数、24 h收缩压负荷、白天收缩压负荷、白天舒张压负荷、夜间收缩压负荷、夜间舒张压负荷、清晨收缩压、清晨舒张压、清晨高血压比例、动态动脉硬化指数(AASI)较非高危组增高,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,AASI是脑血管功能积分异常的独立危险因素[OR=3.16,95%CI(1.68～5.94),P<0.01]。结论动态血压参数变化与脑血管积分异常相关,对高血压患者行动态血压监测及参数分析有利于早期识别靶器官损害,预警脑卒中风险,其中AASI可作为重点监测指标。

Objective To discuss the correlation between cerebrovascular function scores and ambulatory blood pressure parameters in patients with primary hyertension, and to explore the related risk factors of stroke. Methods A total of 328 patients with primary hyertension from the Physical Examination Center in General Hospital of Chongqing from January 2016 to November 2017 were included in the study and received cerebrovascular function testing and ambulatory blood pressure monitoring. Based on the cerebrovascular function score, participants were divided into high-risk stroke group(<75 points) and low-risk stroke group(≥75 points).The differences of ambulatory blood pressure parameters between the two groups were compared. Results The average cerebrovascular function score was 84.48±16.48, with the abnormality rate of 26.83%.The cerebrovascular function score was significantly lower among subjects in high-risk stroke group than that of those in low-risk stroke group(61.18±11.50 vs 93.02 ± 7.02,t=15.151,P<0.01). The 24 h systolic blood pressure(SBP), 24 h diastolic blood pressure(DBP), daytime systolic blood pressure(dSBP), daytime diastolic blood pressure(dDBP), nighttime systolic blood pressure(nSBP), nighttime diastolic blood pressure(nDBP), daytime systolic blood pressure coefficient of variance,24 h systolic blood pressure load, daytime systolic blood pressure load, daytime diastolic blood pressure load, nighttime systolic blood pressure load,nighttime diastolic blood pressure load,morning systolic blood pressure,morning diastolic blood pressure,the ratio of morning hypertension,ambulatory arterial stiffness index(AASI)were all significantly higher among subjects in high-risk stroke group than those in low-risk stroke group(P<0.05).Logistic regression analysis showed that AASI was an independent risk factor of cerebrovascular function score in patients with primary hypertension (OR=3.16,95%CI(1.68-5.94),P<0.01)Conclusions The ambulatory blood pressure monitoring parameters are closely correlated with cerebrovascular function score.The ambulatory blood pressure monitoring may help for the early recognition of the risk of stroke,especially the monitoring of AASI.