男性高龄高血压患者腔隙性脑梗死与夜间血压下降幅度的相关性

摘要

目的 探讨在男性高龄高血压患者中,24 h动态血压及夜间血压下降幅度与腔隙性脑梗死(lacunar infarction,LI)的相关性.方法 以96例男性高龄高血压患者为对象,均行头颅MRI检查和动态血压监测,并同时收集患者的临床和实验室数据.根据LI的数目,将患者分为无/单发LI组25例和多发LI组71例.结果 与无/单发LI组比较,多发LI组患者的夜间平均收缩压明显升高(P=0.01),夜间血压下降幅度明显增大,差异有统计学意义(P=0.00)；2组患者的年龄、吸烟史、饮酒史、冠心病史、高血压病程、总蛋白、尿素、肌酐、尿酸、TC、TG、HDL-C、LDL-C、空腹血糖比较,差异无统计学意义(P＞0.05)；多发LI组患者非杓型血压的发生率显著升高(P=0.01).结论 在高龄高血压患者中,夜间血压异常升高及昼夜节律的异常可能在LI的发展过程中起重要作用.%Objective To study the correlation of 24 h ambulatory blood pressure and nocturnal blood pressure drop magnitude with lacunar cerebral infarction in elderly male hypertensive pa tients. Methods Ninety-six elderly male hypertensive patients were enrolled in this study. They underwent cerebral MRI and 24 h ambulatory blood pressure monitoring,during which their clini cal and laboratory data were collected. The patients were divided into non-single lacunar cerebral infarction group(n=25) and multiple lacunar cerebral infarction group(n = 71) according to the number of lacunar cerebral infarctions. Results The nocturnal systolic pressure,nocturnal pres sure drop magnitude, and incidence of non-dipping blood pressure were significantly higher in multiple lacunar infarction group than in non-single lacunar cerebral infarction group(P = 0. 01). Conclusion Nocturnal blood pressure and abnormal circadian rhythms may play an important role in the development of lacunar cerebral infarction in elderly hypertensive patients.