高血压合并急性缺血性脑卒中患者血压变异性与气温变化的关系研究  

Relationship between blood pressure variability and ambient temperature variation in patients with hypertension complicated with acute ischemic stroke

作　　者：闫宇 王晓雯 谷雨萌 薛娟娟[1] 夏晓爽[1] 王林[2] 李新[1,3] YAN Yu;WANG Xiaowen;GU Yumeng;XUE Juanjuan;XIA Xiaoshuang;WANG Lin;LI Xin(Department of Neurology,the Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Geriatrics,the Second Hospital of Tianjin Medical University,Tianjin 300211,China;Health Meteorological Cross Innovation Center of Tianjin)

机构地区：[1]天津医科大学第二医院神经内科,300211 [2]天津医科大学第二医院保健医疗部老年病科 [3]天津市健康气象交叉创新中心

出　　处：《天津医药》2022年第6期627-632,共6页Tianjin Medical Journal

基　　金：中国脑卒中高危人群干预适宜技术研究及推广项目(GN-2020R0005);天津市科技计划项目(18ZXDBSY00210)。

摘　　要：目的探讨高血压合并急性缺血性脑卒中患者血压变异性(BPV)与气温变化的关系。方法选取原发性高血压患者(高血压组)98例及高血压合并急性缺血性脑卒中患者(合并脑卒中组)112例为研究对象。收集患者年龄、性别和既往病史(糖尿病、冠心病),入院3 d内进行动态血压测量,记录24 h平均收缩压(24 hSBP)、24 h平均舒张压(24 hDBP)、24 h收缩压变异系数(24 hSBPCV)、24 h舒张压变异系数(24 hDBPCV)。记录患者入院当天的日平均气温,分析高血压合并急性缺血性脑卒中者BPV与入院日气温的关系。结果合并脑卒中组24 hSBP、24 hDBP、24 h SBPCV、24 hDBPCV均高于高血压组(P<0.05)。<60岁组患者24 hSBP低于60~<70岁、≥70岁组,≥70岁组患者24 h DBP低于<60岁、60~<70岁组患者,≥70岁组患者24 hSBPCV、24 hDBPCV均高于<60岁、60~<70岁组患者;男性24 h DBP高于女性(P<0.05);糖尿病患者24 hSBPCV、24 hDBPCV高于非糖尿病患者(P<0.05);冠心病患者24 hSBPCV、24 hDBPCV高于非冠心病患者(P<0.05);入院日气温于-13.85~<4.12℃时患者除24 hSBP外,24 hDBP、24 h SBPCV、24 h DBPCV均高于其余入院日气温患者(P<0.05)。多元线性回归显示,高龄、低入院日平均气温为高血压合并急性缺血性脑卒中患者24 hSBP升高的影响因素(P<0.05);高龄为24 hDBP降低的影响因素(P<0.05);高龄、糖尿病史、冠心病史、低入院日平均气温均为24 hSBPCV、24 hDBPCV升高的影响因素(P<0.05)。结论入院日气温较低、高龄、合并冠心病或糖尿病时高血压合并缺血性脑卒中患者BPV升高。Objective To explore the relationship between blood pressure variability(BPV)and ambient temperaturevariation in patients with hypertension complicated with acute ischemic stroke.Methods A total of 98 patients withessential hypertension(hypertension group)and 112 patients with hypertension complicated with acute ischemic stroke(stroke group)were selected as the study subjects.Age,sex and past medical history(diabetes,coronary heart disease)werecollected.And ambulatory blood pressure was measured within 3 days of admission.The 24 h mean systolic blood pressure(24 h SBP),24 h mean diastolic blood pressure(24 h DBP),24 h systolic blood pressure coefficient of variation(24 h SBPCV)and 24 h diastolic blood pressure coefficient of variation(24 h DBPCV)were recorded.The daily mean temperature of eachpatient on admission day was recorded to analyze the relationship between BPV and admission day temperature in patientswith hypertension complicated with acute ischemic stroke.Results The 24 h SBP,24 h DBP,24 h SBPCV and 24 h DBPCVwere significantly higher in the stroke group than those in the hypertension group(P<0.05).The 24 h DBP was lower inthe<60 years old group than that of the 60~<70 years old and≥70 years old group.The 24 h DBP was lower in the≥70 years old group than that of the<60 years old group and 60~<70 years old group,and the 24 h DBPCV and 24 h DBPCVwere higher in the≥70 years old group than those of the<60 years old group and 60~<70 years old group.The 24 h DBP ofmale patients was higher than that of female patients(P<0.05).The 24 hSBPCV and 24 hDBPCV were higher in diabetic patients than those of non-diabetic patients(P<0.05).The 24 hSBPCV and 24 hDBPCV were higher in CHD patients thanthose of non-CHD patients(P<0.05).Except for 24 h SBP,the 24 h DBP,24 h SBPCV and 24 h DBPCV were higher inpatients with admission day temperature between-13.85 and<4.12℃than those of other patients(P<0.05).Multiplelinear regression showed that advanced and low admission daily mean temperature were the influencing fact

关 键 词：高血压 卒中 糖尿病 冠心病 血压变异性 气温 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R544.11[医药卫生—临床医学]