多系统萎缩和帕金森病患者24 h动态血压特点分析  

Characteristics of 24-hour ambulatory blood pressure in patients with multiple system atrophy and Parkinson’s disease

作　　者：刘丽[1] 石金鑫 程晓玲 李婧婧 赵慧[1] 李丽霞[1] 张巍[1] LIU Li;SHI Jinxin;CHENG Xiaoling;LI Jingjing;ZHAO Hui;LI Lixia;ZHANG Wei(Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院,北京100070

出　　处：《中国实用神经疾病杂志》2023年第7期793-797,共5页Chinese Journal of Practical Nervous Diseases

基　　金：国家重点研发计划-欧盟地平线2020计划合作项目(编号:2017YFE0118800-779238);首都医科大学附属北京天坛医院青年科研基金(编号:2015-YQN-14,2015-YQN-15,2015-YQN-17)。

摘　　要：目的研究多系统萎缩(MSA)和帕金森病(PD)患者的24 h血压水平、变异性及昼夜节律情况。方法分析2016-01—2021-01北京天坛医院收治的82例MSA患者(MSA组)及年龄、性别1∶1匹配的82例PD患者(PD组)的临床资料及24 h动态血压参数。比较2组患者的血压水平、变异性及昼夜节律情况。结果(1)MSA组24 h最低收缩压(SBP)和夜间最低SBP高于PD组,差异有统计学意义(P<0.05)。(2)MSA组平均SBP夜间高于日间,平均舒张压(DBP)夜间高于日间,差异有统计学意义(P<0.05);PD组日间与夜间平均SBP、日间与夜间平均DBP比较,差异无统计学意义(P>0.05)。(3)MSA组伴直立性低血压比率高于PD组[55例(67.1%)比23例(28.0%)],伴晨峰血压增高患者比率低于PD组[10例(12.2%)比21例(25.6%)],差异有统计学意义(P<0.05)。(4)2组患者24 h/日间/夜间平均SBP和DBP、24 h/日间/夜间最高SBP和DBP、日间最低SBP和DBP、24 h最低DBP、夜间最低DBP、晨峰平均SBP和DBP比较,差异无统计学意义(P>0.05);2组24 h高血压[34例(41.5%)比34例(41.5%)]、日间高血压[18例(22.0%)比18例(22.0%)]及夜间高血压发生率[66例(80.5%)比59例(72.0%)]比较,差异无统计学意义(P>0.05)。2组24 h、日间及夜间平均SBP和DBP的变异率比较,差异无统计学意义(P>0.05)。2组患者血压节律均以反勺型最多见[56例(68.3%)比52例(63.4%)],其次为非勺型[23例(28.0%)比23例(28.0%)],勺型少见[3例(3.7%)比7例(8.5%)],差异无统计学意义(P>0.05)。结论MSA患者夜间血压明显高于日间血压、伴直立性低血压更多见,在与PD鉴别中具有重要意义。MSA和PD患者血压水平、变异性及昼夜节律较为相似,均表现为病理性昼夜节律,夜间高血压较为普遍。Objective To study the 24-hour blood pressure level,variability and circadian rhythm in pa⁃tients with multiple system atrophy(MSA)and Parkinson’s disease(PD).Methods The clinical data and 24 h ambulatory blood pressure parameters of 82 MSA patients(MSA group)and 82 PD patients(PD group)with age and sex matched in Beijing Tiantan Hospital from January 2016 to January 2021 were analyzed.The blood pres⁃sure level,variability and circadian rhythm of the two groups were compared.Results(1)The 24 h minimum systolic blood pressure(SBP)and nighttime minimum SBP in MSA group were significantly higher than those in PD group(P<0.05).(2)In MSA group,the mean nighttime SBP was significantly higher than the daytime mean SBP(P<0.05),and the nighttime mean diastolic blood pressure(DBP)was significantly higher than the daytime mean DBP(P<0.05),but there was no significant difference between the daytime mean SBP and the nighttime mean SBP,the daytime mean DBP and the nighttime mean DBP in the PD group(P>0.05).(3)The ratio of pa⁃tients with orthostatic hypotension in MSA group was significantly higher than that in PD group(55(67.1%)vs 23(28.0%),P<0.001),while the ratio of patients with morning peak blood pressure increase was significantly lower than that of PD group(10(12.2%)vs 21(25.6%),P<0.05).(4)There were no significant differences in 24 h mean SBP/DBP,daytime mean SBP/DBP,nighttime mean SBP/DBP,24 h maximun SBP/DBP,daytime maximum SBP/DBP,nighttime maximun SBP/DBP,daytime minimum SBP,24 h minimum DBP,daytime minimum DBP,nighttime minimum DBP,morning peak mean SBP and morning peak mean DBP between the two groups(P>0.05).There were no significant differences in the ratio of patients with 24 h hypertension(34(41.5%)vs 34(41.5%)),daytime hypertension((18(22.0%)vs 18(22.0%))and nocturnal hypertension(66(80.5%)vs 59(72.0%))in MSA and PD groups(P>0.05).The variation rate of SBP and DBP in 24 h,daytime and nighttime in the two groups were not significantly different(P>0.05).The most common blood pressure rhythm in MSA and PD

关 键 词：多系统萎缩 帕金森病 24 h动态血压 血压昼夜节律 直立性低血压 

分 类 号：R742.5[医药卫生—神经病学与精神病学]