摘要
目的探讨收缩压及舒张压和不同部位脑白质病变(white matter lesions,WMLs)的相关性。方法回顾性分析2023年1月至12月在重庆医科大学附属第三医院神经疾病中心诊疗的入组患者,按照Fazekas评分标准对入组患者的脑室旁脑白质病变(periventricular WMLs,P-WMLs)和深部脑白质病变(deep WMLs,D-WMLs)的严重程度进行评分。根据Fazekas评分,把P-WMLs患者分为4组(P-WMLs 0分,P-WMLs 1分,P-WMLs 2分,P-WMLs 3分),D-WMLs患者亦分为4组(D-WMLs 0分,D-WMLs 1分,D-WMLs 2分,D-WMLs 3分)。且记录每位入组患者的血压值,并用单因素方差分析进行比较各P-WMLs及D-WMLs病变组之间血压的差异,同时用Logistic回归分析P-WMLs及D-WMLs的危险因素。结果共入组患者966例,其中男487(50.41%)例,平均年龄(65.96±11.35)岁。随着患者P-WMLs和D-WMLs病变程度的加重,患者的收缩压水平[P-WMLs组:0分:(134.41±19.86)mmHg,1分:(136.82±20.47)mmHg,2分:(144.52±21.64)mmHg,3分:(147.80±20.7)mmHg;D-WMLs组:0分:(137.49±20.58)mmHg,1分:(139.17±21.33)mmHg,2分:(144.39±21.20)mmHg,3分:(147.50±21.73)mmHg]随之升高,且差异均有统计学意义(P<0.001)。在P-WMLs和D-WMLs各病变组之间,舒张压水平比较,差异无统计学意义。logistic回归结果表明,收缩压升高(P-WMLs:OR=1.02,95%CI=0.009~0.021;D-WMLs:OR=1.01,95%CI=0.005~0.016)为P-WMLs及D-WMLs病变严重程度增加的独立危险因素,而未发现舒张压升高和P-WMLs和D-WMLs的严重程度具有相关性。结论患者收缩压越高,P-WMLs和D-WMLs病变程度越高;高收缩压是P-WMLs和DWMLs病变严重程度增加的独立危险因素;未发现舒张压水平和P-WMLs和D-WMLs的病变程度具有相关性。
Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(PWMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.
作者
孙梦姣
张云东
程敬
SUN Mengjiao;ZHANG Yundong;CHEN Jing(Department of Neurology&Neurosurgery,Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China)
出处
《中国神经精神疾病杂志》
北大核心
2025年第1期8-14,共7页
Chinese Journal of Nervous and Mental Diseases
关键词
血压
收缩压
舒张压
脑小血管病
脑白质病变
脑室旁脑白质病变
深部脑白质病变
Blood pressure
Systolic blood pressure
Diastolic blood pressure
Cerebral small vessel disease
White matter lesions
Periventricular white matter lesions
Deep white matter lesions
