天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (9): 1008-1011.doi: 10.11958/j.issn.0253-9896.2015.09.014

• 临床研究 • 上一篇    下一篇

血压变异性与高血压小卒中患者急性期神经功能恶化的关系

王渝 朱炬 张哲成△ 张静 田丽 王玉文 孙弦   

  1. 天津市第三中心医院神经内科 （邮编300170）
  • 收稿日期:2014-12-16 修回日期:2015-05-07 出版日期:2015-09-15 发布日期:2015-09-15
  • 通讯作者: △Corresponding Author E-mail:zzc0912@126.com E-mail:avalonpower@163.com
  • 作者简介:王渝 （1983）， 男， 主治医师， 硕士， 主要从事脑血管病、 神经电生理方面研究
  • 基金资助:
    天津市卫生局科技基金资助项目 （2012KR03）

The relationship between blood pressure variability and neurological deterioration during the acute phase in hypertensive minor ischemic stroke patients

WANG Yu, ZHU Ju, ZHANG Zhecheng,△ ZHANG Jing, TIAN Li, WANG Yuwen, SUN Xian   

  1. Department of Neurology, Tianjin Third Central Hospital, Tianjin 300170, China
  • Received:2014-12-16 Revised:2015-05-07 Published:2015-09-15 Online:2015-09-15
  • Contact: △Corresponding Author E-mail:zzc0912@126.com E-mail:avalonpower@163.com

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摘要： 摘要： 目的 探讨血压变异性 （BPV） 与高血压小卒中患者急性期神经功能恶化的关系。方法 选取高血压小卒中患者 200 例， 根据患者是否发生急性期神经功能恶化分为稳定组 （182 例） 和恶化组 （18 例）， 比较 2 组患者 24 h 动态血压监测的 BPV， 24 h 收缩压血压变异系数 （24 h CVSBP ）、 24 h 舒张压血压变异系数 （24 h CVDBP ）、 白昼收缩压血压变异系数 （dCVSBP ）、 白昼舒张压血压变异系数 （dCVDBP ）、 夜间收缩压血压变异系数 （nCVSBP ）、 夜间舒张压血压变异系数（nCVDBP ）。采用 Binary Logistic 回归分析高血压小卒中患者急性期神经功能恶化的 BPV 相关因素。结果 与稳定组比较， 恶化组 24 h CVSBP 为 17.75% （17.54%， 19.26%）vs 12.78% （10.67%， 14.39%）、 24 h CVDBP 为 25.48% （20.77%， 27.87%）vs 17.95%（14.88%， 21.46%）、 dCVSBP 为 18.61%（17.65%， 20.65%）vs 12.30%（10.10%， 14.75%）、 dCVDBP 为 25.65% （21.25%， 29.78%）vs 17.76% （14.89%， 22.19%） 均升高， 差异有统计学意义 （均 P＜0.01）。Binary Logistic 回归分析显示 24 h CVSBP、 dCVSBP 是高血压小卒中患者急性期神经功能恶化的危险因素。结论 24 h BPV 和白昼 BPV 增加可能与高血压小卒中患者急性期神经功能恶化有关， 在卒中急性期和二级预防中应关注 BPV。

关键词: 脑梗死, 高血压, 监护, 血压测定, 脑缺血发作, 短暂性, 卒中, 预后, 血压变异性

Abstract: To investigate the relationship between blood pressure variability (BPV) and neurological deteri⁃ oration (ND) during the acute phase in patients with hypertensive minor ischemic stroke. Methods A total of 200 hyperten⁃ sive patients with acute minor ischemic stroke were recruited in this study. Patients were divided into two groups: stable group (n=182) and deterioration group (n=18) according to the neurological prognosis. Values of BPV in 24 h ambulatoryblood pressure, 24 h systolic blood pressure variation coefficient (24 h CVSBP), 24 h diastolic blood pressure variation coeffi⁃ cient (24 h CVDBP), day time systolic blood pressure variation coefficient (dCVSBP), day time diastolic blood pressure variation coefficient (dCVDBP), night time systolic blood pressure variability (nCVSBP) and night time diastolic blood pressure variability (nCVDBP) were compared between two groups. The related factors of BPV were analyzed by binary logistic method in the acute phase of patients with hypertensive minor ischemic stroke. Results There were significantly higher levels of 24 h CVSBP [17.75% (17.54% ,19.26% ) vs 12.78% (10.67% ,14.39% )], 24 h CVDBP [25.48% (20.77% ,27.87% ) vs 17.95% (14.88% , 21.46%)], dCVSBP [18.61%(17.65%,20.65%) vs 12.30%(10.10%,14.75%)], dCVDBP [25.65%(21.25%,29.78%) vs 17.76% (14.89%,22.19%)] in deterioration group than those of stable group (P＜0.01). Results of binary logistic regression analysis showed that values of 24 h CVSBP and dCVSBP were risk factors for neurological deterioration in the acute phase of patients with hypertensive minor ischemic stroke. Conclusion The increased 24 h BPV and day time BPV are correlated with neurologi⁃ cal deterioration during the acute phase in hypertensive minor ischemic stroke patients. BPV should be concerned in the acute phase and secondary prevention in patients with ischemic stroke.

Key words: brain infarction, hypertension, custodial care, blood pressure determination, ischemic attack, transient, stroke, prognosis, blood pressure variability