天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (6): 627-632.doi: 10.11958/20212733

• 临床研究 • 上一篇    下一篇

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

闫宇1，王晓雯1，谷雨萌1，薛娟娟1，夏晓爽1，王林2，李新1，3△   

  1. 1天津医科大学第二医院神经内科（邮编300211），2保健医疗部/老年病科；3天津市健康气象交叉创新中心
  • 收稿日期:2021-12-13 修回日期:2022-01-29 出版日期:2022-06-15 发布日期:2023-12-20
  • 通讯作者: 闫宇 E-mail:820027015@qq.com
  • 基金资助:
    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）

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

YAN Yu1, WANG Xiaowen1, GU Yumeng1, XUE Juanjuan1, XIA Xiaoshuang1, WANG Lin2, LI Xin1, 3△   

  1. 1 Department of Neurology, 2 Department of Geriatrics, the Second Hospital of Tianjin Medical University, Tianjin 300211, China; 3 Health Meteorological Cross Innovation Center of Tianjin
  • Received:2021-12-13 Revised:2022-01-29 Published:2022-06-15 Online:2023-12-20

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摘要： 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 hDBPCV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。

关键词: 高血压, 卒中, 糖尿病, 冠心病, 血压变异性, 气温

Abstract: Abstract: Objective　To explore the relationship between blood pressure variability (BPV) and ambient temperature variation in patients with hypertension complicated with acute ischemic stroke. Methods　A total of 98 patients with essential 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) were collected. And ambulatory blood pressure was measured within 3 days of admission. The 24 h mean systolic blood pressure (24 hSBP), 24 h mean diastolic blood pressure (24 hDBP), 24 h systolic blood pressure coefficient of variation (24 hSBPCV) and 24 h diastolic blood pressure coefficient of variation (24 hDBPCV) were recorded. The daily mean temperature of each patient on admission day was recorded to analyze the relationship between BPV and admission day temperature in patients with hypertension complicated with acute ischemic stroke. Results　The 24 hSBP, 24 hDBP, 24 hSBPCV and 24 hDBPCV were significantly higher in the stroke group than those in the hypertension group (P＜0.05). The 24 hDBP was lower in the ＜60 years old group than that of the 60~ < 70 years old and ≥70 years old group. The 24 hDBP 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 hDBPCV and 24 hDBPCV were higher in the ≥70 years old group than those of the <60 years old group and 60~ < 70 years old group. The 24 hDBP of male 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 than those of non-CHD patients (P＜0.05). Except for 24 hSBP, the 24 hDBP, 24 hSBPCV and 24 hDBPCV were higher in patients with admission day temperature between -13.85 and ＜4.12 ℃ than those of other patients (P＜0.05). Multiple linear regression showed that advanced and low admission daily mean temperature were the influencing factors for the increase of 24 hSBP in patients with hypertension complicated with acute ischemic stroke (P＜0.05). Advanced age was the influencing factor of 24 hDBP reduction (P＜0.05). Advanced age, history of diabetes mellitus, history of coronary heart disease and low daily mean temperature at admission were the influencing factors for the increase of 24 hSBPCV and 24 hDBPCV (P＜0.05). Conclusion　BPV is increased in patients with low temperature on admission day, advanced age, coronary heart disease or diabetes mellitus.

Key words: hypertension, stroke, diabetes mellitus, coronary disease, blood pressure variability, air temperature