动态血压与急性缺血性卒中患者脑白质病变的关系

发布时间：2018-10-20 16:43

【摘要】：目的探讨动态血压相关指标(ABPM)与急性缺血性卒中患者脑白质病变(WMLs)的关系。方法选择辽宁省人民医院神经内科2012年7月到2014年12月住院治疗的高血压性非心源性栓塞的急性缺血性卒中患者76例,卒中后1~2周内进行ABPM监测及头MRI检查,根据是否存在WMLs,将患者分成2组,有WMLs的作为病例组(36例),无WMLs的作为对照组(40例)。采集一般临床资料,包括年龄、性别、糖尿病史、高脂血症史、吸烟史、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、血糖、纤维蛋白原、同型半胱氨酸等指标及头部MRI影像学资料,并进行ABPM参数的比较。结果年龄、24 h平均收缩压、白天平均收缩压、夜间平均收缩压、夜间平均舒张压、24 h平均脉压病例组和对照组比较差异有统计学意义(均P0.05)。多因素Logistic回归分析显示WMLs的独立危险因素是年龄(OR=0.914,95%CI 0.858~0.975,P=0.006)、24 h平均收缩压(OR=0.810,95%CI 0.651~0.908,P=0.039)、夜间平均舒张压(OR=0.937,95%CI 0.880~0.997,P=0.041)。结论年龄、24 h平均收缩压、夜间平均舒张压是急性缺血性卒中患者WMLs的重要危险因素。
[Abstract]:Objective to investigate the relationship between ambulatory blood pressure (ABPM) and white matter disease (WMLs) in patients with acute ischemic stroke. Methods 76 patients with acute ischemic stroke who were hospitalized in Department of Neurology, Liaoning Provincial people's Hospital from July 2012 to December 2014 were selected for ABPM monitoring and head MRI examination within 1 to 2 weeks after stroke. Patients were divided into two groups according to the presence of WMLs,: 36 cases with WMLs and 40 cases with no WMLs. General clinical data were collected, including age, sex, diabetes, hyperlipidemia, smoking, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, blood glucose, fibrinogen, Homocysteine and head MRI imaging data were compared with ABPM parameters. Results the age, 24 h mean systolic blood pressure, daytime mean systolic blood pressure, night mean diastolic blood pressure, 24 h mean pulse pressure were significantly different from the control group (P0.05). Multivariate Logistic regression analysis showed that the independent risk factors for WMLs were age (OR=0.914,95%CI 0.858), mean systolic blood pressure (OR=0.810,95%CI) at 24 h (OR=0.810,95%CI 0.651V 0.908) and nighttime mean diastolic blood pressure (OR=0.937,95%CI 0.880). Conclusion Age, 24 h mean systolic blood pressure and night mean diastolic blood pressure are important risk factors for WMLs in patients with acute ischemic stroke.
【作者单位】：辽宁省人民医院神经内科;中国医科大学附属第一医院神经内科;
【基金】：辽宁省自然科学基金(201202276)
【分类号】：R743.3

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