脑梗死合并高血压患者血压变异性、血压晨峰与动脉粥样硬化的相关性

摘要

目的 探讨脑梗死合并高血压患者血压变异性、血压晨峰与动脉粥样硬化的相关性.方法 选取2015年1月至2016年8月住院的脑梗死合并高血压患者132例进行颈部彩色多普勒超声检查,根据血管内膜中层厚度(IMT)分为IMT正常组20例,IMT增厚组56例,IMT斑块组56例,后2组判定为颈动脉粥样硬化.另外,根据24 h动态血压监测结果将132例患者分为非晨峰组49例和晨峰组83例.测定各组血脂、24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、日间平均收缩压(dSBP)、日间平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、血压变异性、血压晨峰及神经功能缺损程度评分(NIHSS)、日常生活能力评分(BI).结果 IMT正常组、IMT增厚组、IMT斑块组TG、TC、LDL-C、HDL-C、ApoA、ApoB、Hcy、hs-CRP、24 h SBP、24 h DBP、dSBP、dDBP、nSBP、nDBP、24 h SBPV、dSBPV、血压晨峰检出率、NIHSS、BI评分比较差异均有统计学意义(P<0?.05).结论 脑梗死合并高血压患者血脂、Hcy、hs-CRP、24 h SBPV、dSBPV、血压晨峰与动脉粥样硬化有关,是导致动脉粥样硬化发生发展的独立危险因素.%Objective To investigate the correlation between blood pressure variability ,blood pressure morning surge and atherosclerosis( AS) in patients with cerebral infarction complicated by hypertension .Mtehods One hundred and thirty-two patients with cerebral infarction complicated by hypertension who were admitted and treated in our hospital from January 2015 to August 2016 were enrolled in the study .These patients were examined by color Doppler ultrasound to measure intimae-media thickness ( IMT) of carotid artery .All the patients were divided into 3 groups according to IMT:20 patients in normal IMT group ,56 patients in IMT thickening group and 56 patients in IMT plaque group ,and the patients in the latter two groups were regarded as AS .Moreover according to 24-hour ambulary blood pressure monitoring results the 132 patients were divided into the non-morning surge group ( n =49) and morning surge group ( n =83).The biochemical indexes including blood lipids,24-hour average systolic blood pressure (24h SBP),24-hour mean diastolic blood pressure (24h DBP),daytime average systolic blood pressure ( dSBP ) , nighttime diastolic blood pressure ( dDBP ) , nocturnal mean systolic blood pressure (nSBP), nocturnal mean diastolic blood pressure (nDBP),blood pressure variability, blood pressure morning surge and NIHSS scores as well as BI scores were analyzed and compared among groups .Rseults There were significant differences in the levels of TG ,TC,LDL-C,HDL-C,ApoA,ApoB,Hcy,hs-CRP,24 h SBP,24 h DBP,dSBP,dDBP,nSBP,nDBP,24h SBPV, dSBPV, detection rate of blood pressure morning surge ,NIHSS scores,BI scores among normal IMT group ,IMT thickening group and IMT plaque group ( P <0.05).Conclusion The blood lipid,Hcy,hs-CRP,24 h SBPV,dSBPV,blood pressure morning surge in patients with cerebral infarction complicated by hypertension is correlated to atherosclerosis , which are independentrisk factors resulting in the pathogenesis and development of artherosclerosis .