摘要
目的探讨长时血压变异性（BPV）与脑白质疏松（L A）的关系。方法收集2011年6月-2013年6月于浙江医院神经内科就诊患者209例,每月随诊测血压1次,随访12个月,MRI采集患者脑白质病变图像并依据Fazekas量表分为LA 0–3级,比较LA组与非LA组以及LA组内各级之间的一般资料、长时血压及变异性指标并进行相关回归分析。结果 LA组138例,非LA组71例,两组患者年龄、高血压病、卒中史之间的差异有统计学意义（P〈0.05）。LA组收缩压最大值、长时平均血压、血压标准差（SD）、血压变异系数（CV）及独立于均值的血压变异系数（VIM）均高于非L A组。L A组内各级比较,收缩压最大值差异有统计学意义（P〈0.05）,L A 3级患者的长时平均收缩压以及长时血压SD、CV和VIM高于LA 1级患者（P〈0.05）。多因素分析显示,长时平均舒张压（OR=1.048,95%CI 1.028~1.067）、收缩压SD（OR=1.064,95%CI 1.001~1.131）、CV（OR=1.086,95%CI 1.002~1.177）、VIM（OR=1.060,95%CI 1.001~1.122）和舒张压SD（OR=1.111,95%CI 1.000~1.233）、CV（OR=1.091,95%CI 1.001~1.190）与LA独立相关（P〈0.05）。结论长时平均舒张压与长时BPV与LA密切相关。
Objective To investigate the correlation between long-term blood pressure variability （BPV） and leukoaraiosis （LA）. Methods Blood pressure was measured monthly in 209 patients visiting Zhejiang Hospital during June 2011 to June 2013, and they were followed up for 12 months. The patients were divided into LA 0-3 groups according to the MRI results and Fazekas scale. The clinical information, long-term blood pressure, and the index of long-term BPV were compared between LA groups and non-LA group, and among patients with different levels of LA, and then the correlation was regressively analyzed. Results One hundred and thirty- eight patients in LA group, and 71 in non-LA group. Regression analysis revealed that significant differences in age and the history of： hypertension and occurrence of stroke between LA groups and non-LA group （P〈0.0$）. The maximal systolic blood pressure, the mean value of long-term blood pressure, the standard deviation （SD）, coefficient of variation （CV）, and variatio independent of mean （VIM） of blood pressure were higher in LA groups than in non-LA group （P〈0.05）. There was significant difference in maximun systolic pressure between every level of LA groups （P〈0.05）. The mean long-term systolic blood pressure and SD, CV and VIM of long-term blood pressure were significantly higher in the patients of LA3 group than that in the patients of LA1 group （P〈0.05）. Logistic regression analysis showed that the mean long-term diastolic blood pressure （OR=1.048, 95% CI 1.028-1.067）, systolic blood pressure SD （OR=1.064, 95% CI 1.001-1.131）, CV （OR=1.086, 95% CI 1.002-1.177）, VIM （OR=1.060,95% CI 1.001-1.122）, and diastolic blood pressure SD （OR=1.111, 95% CI 1.000-1.233） and CV （OR=1.091, 95% CI 1.001-1.190） were the independent risk factors ofLA （P〈0.05）. Conclusion There is a significant correlation between long-term diastolic blood pressure and long-term BPV and LA.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2015年第2期142-146,共5页
Medical Journal of Chinese People's Liberation Army
基金
浙江省卫生厅课题(2011KYB022)~~
关键词
血压变异性
脑白质疏松
血压
blood pressure variability
leukoaraiosis
blood pressure
