动态血压与老老年高血压脑白质疏松患者认知功能的关系

摘要

Objective To analyze the relationship between ambulatory blood pressure (ABP) and cognitive function in elderly hypertensive patients with leukoaraiosis (LA).Methods Eighty elderly hypertensive patients with LA underwent 24 h ABP monitoring to record their 24 h SBPV,DBPV,AASI,and APPI.The patients were scored according to the MMSE Scale.Results The 24 h SBPV,DBPV,AASI,and APPI were significantly higher in degrees 1,2,3 of LA than in degree 0 of LA (P＜0.05),in degrees 2,3 of LA than in degree 1 of LA (P＜0.05),and in degree 3 of LA than in degree 2 of LA (P＜0.05).The MMSE Scale score of memory,attention,counting,recall,language and the total score were significantly lower in degrees 2,3 of LA than in degrees 1,2 of LA (P＜0.05).The 24 h SBPV,DBPV,AASI,and APPI were negatively related with the MMSE Scale score (r=-0.8697,P=0.000;r=-0.6709,P=0.002;r=-0.8373,P=0.000;r=-0.5991,P=0.007).Conclusion The severer the LA is,the higher the 24 h SBPV,AASI and APPI are.The 24 h SBPV and AASI can thus be used as the indicators of LA and cognitive function impairement.%目的 比较老老年高血压患者不同程度脑白质疏松(teukoaraiosis,LA)的动态血压参数与认知功能的相关性.方法 对80例老老年高血压患者行24 h动态血压监测,观察24 h收缩压变异性(systolic blood pressure variability,SBPV)、24 h舒张压变异性(diastolic blood pressure variability,DBPV)、动态动脉硬化指数(ambulatory arterial stiffness index,AASI)、动态脉压指数(ambulatory pulse pressure index,APPI)等;并对患者行简易智能状态检查量表(MMSE)评估.结果 与LA 0级比较,1级、2级、3级的24 h SBPV、24 h DBPV、AASI、APPI增大(P＜0.05);与LA 1级比较,2级、3级24 h-SBPV、24 h-DBPV、AASI、APPI增大(P＜0.05);LA 3级的24 h-SBPV、AASI和APPI显著高于2级,差异有统计学意义(P＜0.05).与LA 0级、1级比较,2级、3级的记忆力、注意力和计算力、回忆能力、语言能力和总分显著降低,差异有统计学意义(P＜0.05).24h SBPV(r=-0.8697,P=0.000)、24 h DBPV(r=-0.6709,P=0.002)、AASI(r=-0.8373,P=0.000)、APPI(r=-0.5991,P=0.007)与MMSE呈显著负相关.结论 LA程度越重,24 h SBPV、AASI、APPI越大;24 h SBPV、AASI可能作为LA、认知功能下降的预测指标.