急性脑梗死患者血压变异性的临床研究  

Clinical Research on Blood Pressure Variability of Patients with Acute Cerebral Infarction

作　　者：李寅珍 金义兵 胡东芳[1,2] 朱莉[1,2] 黎玉环 乔洪源[1,2] 

机构地区：[1]武汉大学基础医学院生物工程系,武汉430000 [2]宜昌市三峡大学第二人民医院神经内科

出　　处：《数理医药学杂志》2016年第10期1423-1426,共4页Journal of Mathematical Medicine

摘　　要：目的：通过对急性脑梗死患者血压变异性（BPV）的研究,指导更有效地控制血压,预防脑梗死。方法：利用前瞻队列研究方法将急性脑梗死患者按CISS分型方法分为大动脉粥样硬化型（LAA）,心源性脑栓塞型（CS）,穿支病变型（PAD）,其它原因型（OE）和不明原因型（UE）。在入院后1-2周内行24h动态血压监测（ABPM）,比较前三者之间以及其与单纯高血压病（HBP）之间血压变异性的差异性。结果：尿白蛋白在LAA组与PAD组、LAA组与HBP组、PAD组与CS组、CS组与HBP之间差异具有统计学意义（P〈0.05）。24h-sBP在LAA组与PAD组、LAA组与CS组之间差异具有统计学意义（P〈0.05）。n-sBP在LAA组与PAD组之间差异具有统计学意义（P〈0.05）。n-dBPCV在LAA组与HBP组之间差异具有统计学意义（P〈0.05）。d-sBP负荷在LAA组与CS组、PAD组与CS组、CS组与HBP组之间差异具有统计学意义（P〈0.05）。IMT指标在LAA组与HBP组之间差异具有统计学意义（P〈0.05）。IVST指标在LAA组与PAD组、LAA组与HBP组之间差异具有统计学意义（P〈0.05）。结论：不同类型的急性脑梗死患者其血压变异性有差异,持续收缩压升高特别是夜间收缩压升高以及夜间舒张压变异系数增大是导致大动脉粥样硬化的主要原因,也是导致其他靶器官受损的主要原因。24h平均收缩压、白昼收缩压负荷及夜间舒张压变异性与靶器官受损呈正相关,是大动脉粥样硬化型脑梗死的预测因子。Objective：Through the study of blood pressure variability（BPV）in patients with acute cerebral infarction,to guide more effective control of blood pressure,and to prevent cerebral infarction.Methods：Using the prospective cohort study method,The patients with acute cerebral infarction were divided into large artery atherosclerosis（LAA）、cardiogenic stroke（CS）、penetrating artery disease（PAD）,other determined etiology（OE）and undetermined etiology（UE）by China Ischemic Stroke Subclassification（CISS）.Every patients received 24 hour ambulatory blood pressure monitoring（ABPM）in the hospital for a week to two weeks,compared the blood pressure variability differences among the first three types and the differences between them and high blood pressure.Results：The MALB difference between LAA and PAD、LAA and HBP、PAD and CS、CS and HBP was statistically significant（P〈0.05）.The 24h-sBP difference between LAA and PAD、LAA and CS was statistically significant（P〈0.05）.The n-sBP difference between LAA and PAD was statistically significant（P〈0.05.The n-dBPCV difference between LAA and HBP was statistically different（P〈0.05）.The d-sBP difference between LAA and CS、PAD and CS、CS and HBP was statistically significant（P〈0.05）.The IMT difference between LAA and HBP was statistically significant（P〈0.05）.The IVST difference between LAA and PAD、LAA and HBP was statistically significant（P〈0.05）.Conclusion：The blood pressure variability differs in the different types of acute cerebral infarction patients.Sustained elevated systolic blood pressure,especially the nocturnal blood pressure increase and nocturnal diastolic blood pressure variation coefficient increases,was the main cause of atherosclerosis and the main reason for other target organ damage.24 hours mean systolic blood pressure,daytime systolic blood pressure and diastolic blood pressure variability were positively correlated with target organ damage,which is a predictive factor for the lar

关 键 词：急性脑梗死 CISS分型 24H动态血压监测 血压变异性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]