脑白质疏松患者动态血压的Logistic回归分析  

Analysis of 24-hour ambulatory blood pressure profiles in leukoaraiosis

作　　者：黄勇华[1,2] 张微微[1] 林琅[1] 冯军[1] 郭文华[1] 魏微[1] 李莉[1] 

机构地区：[1]北京军区总医院神经内科,北京100700 [2]第三军医大学

出　　处：《北京医学》2009年第5期270-272,共3页Beijing Medical Journal

摘　　要：目的探讨24h动态血压节律变化与脑白质疏松发生的关系。方法总结2006年1月至2008年7月因急性腔隙性脑梗死住院的87例患者的资料,将头颅磁共振(MRI)所见脑白质疏松按照Fazekas评分标准分为无/轻度组(0～1分)和中重度组(2～3分);采用无创性携带式动态血压监测仪进行动态血压监测和Logistic回归分析。结果无/轻度组40例,中重度组47例。将年龄、糖尿病等纳入多因素Binarylogistic回归分析提示,24h平均DBP(OR=1.077,95%CI:1.001～1.158,P=0.044)、白昼平均SBP(OR=1.091,95%CI:1.020～1.167,P=0.011)、白昼平均DBP(OR=1.176,95%CI:1.016～1.360,P=0.029)、夜间SBP下降百分比(OR=0.348,95%CI:0.180～0.673,P=0.002)是LA发生、发展的危险因素。结论脑白质疏松患者血压异常增高及昼夜节律消失可能参与白质疏松的发病机制。Objective To investigate the relationship between 24 hour ambulatory blood pressure profiles and leukoaraiosis（LA）. Methods Eighty-seven patients of acute lacunar infarcts admitted to Beijing Military General Hospital from January 2006 and July 2008 were analyzed retrospectively. All patients were divided into absent/mild group and moderate/severe group according to Fazekas scores of leukoaraiosis on MRI. Results There were 40 eases of leukoaraiosis in absent/mide group and 47 cases in moderate/severe group. Binary logistic regression analysis indicated that the major risk factors for LA included 24-hour mean DBP （OR=1.077, 95%CI： 1.001-1.158, P=0.044）, daytime mean SBP（OR= 1.091, 95%CI ： 1.020-1.167, P=-0.011 ）, daytime mean DBP（OR= 1.176, 95 %CI ： 1.016-1.360, P=0.029）, and the percentage of reduction of nighttime SBP （OR=0.348, 95%CI ：0.180-0.673, P=-0.002）. Conclusions The abnormal increase and disappeared circadian variation of blood pressure may be involved in the pathogenesis of leukoaraiosis.

关 键 词：脑白质疏松 动态血压监测 LOGISTIC回归分析 发病机制 

分 类 号：R742.89[医药卫生—神经病学与精神病学]