中国医科大学学报

中国医科大学学报

中国医科大学学报

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动态血压与急性缺血性卒中患者脑白质病变的关系

慕经纬1,王凝1,赵传胜2   

  1. 1. 辽宁省人民医院神经内科,沈阳110016;2. 中国医科大学附属第一医院神经内科,沈阳110001
  • 收稿日期:2015-08-04 出版日期:2016-01-05 发布日期:2015-12-30
  • 通讯作者: 赵传胜,E-mail:zhaochsh@hotmaill.com
  • 作者简介:慕经纬(1983 -),女,主治医师,硕士.
  • 基金资助:

    辽宁省自然科学基金(201202276)

Correlation Study of Ambulatory Blood Pressure and White Matter Lesions in Acute Ischemic Stroke Patients

MU Jing-wei1,WANG Ning1,ZHAO Chuan-sheng2   

  1. 1.Department of Neurology,The People’s Hospital of Liaoning Province,Shenyang 110016,China;2. Department of Neurology,The First Hospital,China Medical University,Shenyang110001,China
  • Received:2015-08-04 Online:2016-01-05 Published:2015-12-30

摘要:

目的 探讨动态血压相关指标(ABPM)与急性缺血性卒中患者脑白质病变(WMLs)的关系。方法 选择辽宁省人民医院神经内科2012年7月到2014年12月住院治疗的高血压性非心源性栓塞的急性缺血性卒中患者76例,卒中后1~2周内进行ABPM监测及头MRI检查,根据是否存在WMLs,将患者分成2组,有WMLs的作为病例组(36例),无WMLs的作为对照组(40例)。采集一般临床资料,包括年龄、性别、糖尿病史、高脂血症史、吸烟史、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、血糖、纤维蛋白原、同型半胱氨酸等指标及头部MRI影像学资料,并进行ABPM参数的比较。结果 年龄、24 h平均收缩压、白天平均收缩压、夜间平均收缩压、夜间平均舒张压、24 h平均脉压病例组和对照组比较差异有统计学意义(均P < 0.05)。多因素Logistic回归分析显示WMLs的独立危险因素是年龄(OR =0.914,95% CI 0.858~0.975,P = 0.006)、24 h平均收缩压(OR =0.810,95%CI 0.651~0.908,P = 0.039)、夜间平均舒张压(OR =0.937,95%CI 0.880~0.997,P = 0.041)。结论 年龄、24 h平均收缩压、夜间平均舒张压是急性缺血性卒中患者WMLs的重要危险因素。

关键词: 脑白质病变, 动态血压, 缺血性卒中

Abstract:

Objective To describe the association between white matter lesionsWMLsand ambulatory blood pressure monitoringABPMparameters in acute ischemic stroke patients. Methods A total of 76 noncardioembolic ischemic stroke patients with hypertention admitted from July 2012 to December 2014 were recruited. These patients had 1 week of suffering a strokeand received ABPM and MRI 1 or 2 weeks after stroke onset. The subjects were classified into 2 groups according to the presence of WMLswith WMLs groupn =36),without WMLs groupcontrol groupn =40. The clinical data of these patients were collectedincluding agegenderhistory of diabeteshistory of hyperlipidemiahistory of smokingtotal cholesterolhigh-density lipoproteinlow-density lipoproteintriglycerideblood glucoseand homocysteine. Their ABPM parameters were compared. Results Age24-hour SBPawakeand asleep systolic blood pressureSBP/diastolic blood pressure levels and 24-hour pulse pressure were associated with advanced WMLs. After adjustmentsold ageOR =0.91495% CI 0.858-0.975P = 0.006),high 24-hour SBP levelsOR =0.81095%CI 0.651-0.908P = 0.039),and asleep DBPOR =0.93795%CI 0.880-0.997P = 0.041were independently risk factors for WMLs in stroke patients. Conclusion Agehigher24-hour SBP and asleep DBP are correlated with WMLs in ischemic stroke patients.

Key words: white matter lesions, ambulatory blood pressure, ischemic stroke

中图分类号: 

  • R743.3
[1] 张潇怡, 问文敏, 张添甜, 赵紫薇, 孙光. 老年原发性高血压合并舒张性心力衰竭患者的临床特点分析[J]. 中国医科大学学报, 2015, 44(9): 803-805.
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