进展性脑梗死与血压晨峰的相关性及其危险因素分析  

Correlation between Morning Blood Pressure Peak and Progressive Cerebral Infarction and Risk Factors Analysis

作　　者：李宏锦 于海洋 周学军 李景莉 刘占矿[5] LI Hongjin;YU Haiyang;ZHOU Xuejun;LI Jingli;LIU Zhankuang(Graduate School of Hebei North University,Zhangjiakou 075000,China;Department of Neurology,,Hospital of the 81st Army,Zhangjiakou 075000,China;Department of Imaging,Hospital of the 81st Army,Zhangjiakou 075000,China;Department of Operating Room,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou 075000,China;Department of Gerontology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院研究生院,河北张家口075000 [2]陆军第八十一集团军医院神经内科,河北张家口075000 [3]陆军第八十一集团军医院影像科,河北张家口075000 [4]张家口市妇幼保健院手术室,河北张家口075000 [5]河北北方学院附属第一医院老年科,河北张家口075000

出　　处：《医学综述》2022年第6期1229-1233,共5页Medical Recapitulate

基　　金：张家口市重点研发计划项目(2021092D)。

摘　　要：目的分析进展性脑梗死与血压晨峰的相关性及其危险因素。方法选取2020年10月至2021年6月陆军第八十一集团军医院收治的150急性脑梗死患者作为研究对象,收集患者性别、年龄、血压晨峰值等资料,根据是否为进展性脑梗死分为进展组与非进展组,对比两组患者相关病历资料,分析血压晨峰与进展性脑梗死的相关性及进展性脑梗死的危险因素。结果根据斯堪的那维亚卒中量表评分结果,进展组49例、非进展组101例。进展组患者高脂血症史、颅内外大动脉狭窄、心房颤动的比例高于非进展组(P<0.05或P<0.01),发病至开始治疗时间明显长于非进展组(P<0.01),夜间平均动脉压(MAP)明显低于非进展组(P<0.01),纤维蛋白原、日间MAP、24 h MAP、血压晨峰明显高于非进展组(P<0.05或P<0.01)。多因素Logistic回归分析结果显示,颅内外大动脉狭窄、心房颤动以及纤维蛋白原、夜间MAP、日间MAP、24 h MAP、血压晨峰是进展性脑梗死的独立危险因素(OR=2.683,95%CI 1.104~6.520;OR=2.401,95%CI 1.044~5.523;OR=4.043,95%CI 1.171~13.953;OR=4.938,95%CI 1.245~19.587;OR=5.296,95%CI 1.102~25.456;OR=4.096,95%CI 1.135~14.788;OR=3.877,95%CI 1.438~10.452)(P<0.05或P<0.01)。Pearson相关分析结果显示,进展性脑梗死与血压晨峰呈显著正相关(r=0.207,P=0.011)。结论颅内外大动脉狭窄、心房颤动等为进展性脑梗死的危险因素,血压晨峰与进展性脑梗死呈显著正相关,监测并控制血压晨峰对防治进展性脑梗死、改善患者预后具有重要意义。Objective To analyze the correlation between progressive cerebral infarction and morning blood pressure peak and related risk factors.Methods A total of 150 patients with acute cerebral infarction treated in Hospital of the 81st Army from Oct.2020 to Jun.2021 were included,and information of the patients′gender,age,blood pressure data such as morning peak was collected.According to whether developed into progressive cerebral infarction,the patients were divided into a progressive group and a non-progressive group,and the related medical records were recorded,and the correlation between morning peak blood pressure and progressive cerebral infarction and the related risk factors were analyzed.Results According to the Scandinavian stroke scale(SSS)score results of the 150 patients,49 patients were assigned into the progressive group and 101 patients into the non-progressive group.The proportions of patients with hyperlipidemia history,intracranial and extracranial arterial stenosis,and atrial fibrillation in the progressive group were higher than those in the non-progressive group(P<0.05 or P<0.01),the time from onset to treatment was significantly longer than that in the non-progressive group(P<0.01),and the nighttime mean arterial pressure(MAP)was significantly lower than that in the non-progressive group(P<0.01).Fibrinogen,daytime MAP,24 h MAP and morning peak of blood pressure were significantly higher than those in the non-progressive group(P<0.05 or P<0.01).Multivariate Logistic regression analysis showed that intracranial and extracranial arterial stenosis,atrial fibrillation,fibrinogen,nighttime MAP,daytime MAP,24 h MAP and morning peak blood pressure were independent risk factors for progressive cerebral infarction(OR=2.683,95%CI 1.104-6.520;OR=2.401,95%CI 1.044-5.523;OR=4.043,95%CI 1.171-13.953;OR=4.938,95%CI 1.245-19.587;OR=5.296,95%CI 1.102-25.456;OR=4.096,95%CI 1.135-14.788;OR=3.877,95%CI 1.438-10.452)(P<0.05 or P<0.01).Pearson correlation analysis showed that there was a significant positive correlat

关 键 词：进展性脑梗死 血压变异性 血压晨峰 平均动脉压 

分 类 号：R743.33[医药卫生—神经病学与精神病学]