摘要
目的探讨缺血性脑卒中患者血压变异性与大脑中动脉狭窄的相关性,为缺血性脑卒中合并原发性高血压患者的管理和大脑中动脉狭窄的防治提供依据。方法回顾性纳入186例大脑中动脉供血区的缺血性脑卒中患者,分为大脑中动脉狭窄组(n=94)和无狭窄组(n=92),大脑中动脉狭窄组再分为轻度、中度、重度狭窄组,收集所有患者一般临床资料以及24h动态血压监测所获得的不同时段收缩压(systolic blood pressure,SBP)及舒张压(diastolic blood pressure,DBP)数据,采用平均真实变异性(average real variability,ARV)计算公式计算血压变异性,分析血压变异性与大脑中动脉狭窄及狭窄严重程度的相关性。结果大脑中动脉狭窄组24h SBPARV、dSBPARV、nSBPARV水平均高于无狭窄组,差异有统计学意义(P<0.05),二分类多因素Logistic分析结果显示,24h SBPARV(OR=1.497,95%CI:1.089~2.057,P<0.05)对大脑中动脉狭窄影响差异有统计学意义;24h SBPARV、dSBPARV均与大脑中动脉狭窄严重程度之间呈正相关(r分别为0.607、0.577,P均<0.001)。结论日间及夜间收缩压变异性是大脑中动脉狭窄的重要危险因素,全天收缩压变异性是大脑中动脉狭窄的独立危险因素。24h SBPARV、dSBPARV是评估大脑中动脉狭窄严重程度的可靠指标,并且与大脑中动脉狭窄严重程度呈正相关,即全天及日间收缩压变异性越大,大脑中动脉狭窄严重程度越严重。
Objective To investigate the correlation between blood pressure variability and middle cerebral artery(MCA)stenosis in patients with ischemic stroke,and to provide a basis for the management of patients with ischemic stroke combined with primary hypertension and the prevention and treatment of MCA stenosis.Methods Retrospectively,186 patients with ischemic stroke in the MCA supply area were included and divided into MCA stenosis group(94 patients)and no stenosis group(92 patients),and the MCA stenosis group was subdivided into mild,moderate and severe stenosis groups.General clinical data,systolic blood pressure(SBP)and diastolic blood pressure(DBP)data obtained from 24-hour ambulatory blood pressure monitoring at different time periods were collected from all patients,and blood pressure variability was calculated using the average real variability(ARV)calculation formula.We analyzed the correlation of blood pressure variability with MCA stenosis and stenosis severity.Results 24hSBPARV,dSBPARV,and nSBPARV levels were higher in the MCA stenosis group than in the no-stenosis group,and the differences were statistically significant(P<0.05),and results from dichotomous multivariate Logistic analysis showed that 24hSBPARV(OR=1.497,95%CI:1.089-2.057,P<0.05)had a significant impact on the middle artery stenosis.There was a positive correlation between 24hSBPARV and dSBPARV and the severity of MCA stenosis(r were 0.607,0.577,all P<0.001).Conclusion The daytime and nighttime systolic pressure variability is an important risk factor for MCA stenosis,and systolic pressure variability throughout the day is an independent risk factor for MCA stenosis.24hSBPARV and dSBPARV are reliable indicators for assessing the severity of MCA stenosis and are positively correlated with the severity of MCA stenosis,i.e.,the greater the variability of systolic pressure throughout the day and daytime,the more severe the possible severity of MCA stenosis.
作者
张红岩
陈志斌
李威
许苗菁
ZHANG Hongyan;CHEN Zhibin;LI Wei(Department of Neurology,The First Affiliated Hospital of Hainan Medical College,Hainan 570100,China)
出处
《医学研究杂志》
2023年第8期163-167,共5页
Journal of Medical Research
基金
海南省博士后科研基金资助项目(2019M20273)。
关键词
缺血性脑卒中
血压变异性
大脑中动脉狭窄
平均真实变异性
Ischemic stroke
Blood pressure variability
Middle cerebral artery stenosis
Average real variability
