AIS血压变异性对颈动脉粥样硬化及认知功能影响  

INFLUENCE OF BLOOD PRESSURE VARIABILITY ON CAROTID ATHEROSCLEROSIS AND COGNITIVE FUNCTION IN ACUTE ISCHEMIC STROKE

作　　者：肖悠美[1] 孙晓静[1] XIAO Youmei;SUN Xiaojing(Department of Neurology,Zhengzhou People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州人民医院神经内科,河南郑州450000

出　　处：《青岛大学学报（医学版）》2023年第5期740-744,共5页Journal of Qingdao University(Medical Sciences)

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ-20191066)。

摘　　要：目的探究急性缺血性脑卒中(AIS)病人血压变异性对颈动脉粥样硬化(CAS)及认知功能的影响。方法前瞻性选取2020年3月—2021年2月郑州人民医院收治的AIS病人335例,运用Logistic回归模型对AIS病人CAS及认知功能障碍进行单因素和多因素分析,采用Pearson检验分析AIS病人血压变异性指标与CAS及认知功能障碍的相关性。结果Logistic单因素和多因素分析结果表明,病人年龄、同型半胱氨酸(Hcy)、糖化血红蛋白(HbA1c)、24 h平均舒张压(24h MDBP)、24 h平均收缩压(24h MSBP)、24 h舒张压变异系数(24h DBP-CV)和24 h收缩压变异系数(24h SBP-CV)均为AIS病人CAS的影响因素(OR=1.652~3.795,95%CI=(1.227~2.853)~(2.301~17.142),P均<0.05);病人年龄、教育程度、糖尿病史、24h MDBP、24h MSBP、24h DBP-CV和24h SBP-CV等均为AIS病人认知功能障碍的影响因素(OR=1.613~3.177,95%CI=(1.206~2.113)~(2.241~10.024),P均<0.05)。AIS病人24h MDBP、24h MSBP、24h DBP-CV、24h SBP-CV均与CAS(r=0.426~0.495,P均<0.05)及认知功能障碍(r=0.433~0.536,P均<0.05)存在正向相关性。结论血压变异性是AIS病人CAS及认知功能障碍的重要影响因素,临床应密切关注并监测AIS病人血压水平变化,有效控制血压变异性或者降低血压波动幅度,以降低发生CAS及认知功能障碍风险。Objective To investigatethe influenceof blood pressure variability on carotid atherosclerosis(CAS)and cognitive function in patients with acute ischemic stroke(AIS).Methods A prospective randomized trial was conducted among 335 AIS patients who were admitted to Zhengzhou People’s Hospital from March 2020 to February 2021.The logistic regression model was used to perform univariate and multivariate analyses to identify the influencing factors forCAS and cognitive function in patients with AIS,and a Pearson correlation analysis was used to investigate the correlation of blood pressure variability parameters with CAS and cognitive dysfunction in patients with AIS.Results The univariate and multivariate Logistic regression analyses showedthat patient age,homocysteine(Hcy),glycated hemoglobin(HbA1c),mean 24 h diastolic blood pressure(24h MDBP),mean 24 h systolic blood pressure(24h MSBP),24 h DBP coefficient of variation(24h DBP-CV),and 24 h SBP coefficient of variation(24h SBP-CV)were all influencing factors for CAS in AIS patients(OR=1.652-3.795,95%CI=1.227-2.853 to 2.301-17.142,all P<0.05),and patient age,educational background,history of diabetes mellitus,24h MDBP,24h MSBP,24h DBP-CV,and 24h SBP-CV were influencing factors forcognitive dysfunction in AIS patients(OR=1.613-3.177,95%CI=1.206-2.113 to 2.241-10.024,all P<0.05).The Pearson correlation analysis showedthat 24h MDBP,24h MSBP,24h DBP-CV,and 24h SBP-CV were positively correlated with CAS(r=0.426-0.495,all P<0.05)and cognitive dysfunction(r=0.433-0.536,all P<0.05)in AIS patients.Conclusion Blood pressure variability is an important influencing factor for CAS and cognitivedysfunction in AIS patients.In clinical practice,it is necessary to closely monitor the change in blood pressure and effectively control blood pressure variability or reducein the magnitude of blood pressure fluctuation,so as to reduce the risk of CAS and cognitive dysfunction in AIS patients.

关 键 词：卒中 血压监测仪 颈动脉疾病 认知功能障碍 影响因素分析 LOGISTIC模型 

分 类 号：R743[医药卫生—神经病学与精神病学] R443.5[医药卫生—临床医学]