急性前循环脑梗死患者血压变异性与颈动脉粥样硬化斑块的相关性

摘要

目的 探讨急性前循环脑梗死患者血压变异性与颈动脉粥样硬化斑块的相关性,为临床预防控制动脉硬化提供依据.方法 将2012年6月～2016年6月我院收治的符合纳入标准的急性前循环脑梗死患者236例分为颈动脉狭窄组(206例)和非颈动脉狭窄组(30例),其中颈动脉狭窄组患者依照颈动脉狭窄程度是否大于50％分为狭窄程度＜50％组(142例)和狭窄程度≥50％组(64例).患者在入院三天时行颈动脉超声检查,入院5～7 d进行动态血压监测.结果 狭窄组夜间收缩压标准差(nSSD)、日间舒张压标准差(dDSD)及日间收缩压标准差(dSSD)高于非狭窄组(P＜0.05);狭窄组与非狭窄组两组血压昼夜节律差异有统计学意义(P＜0.05);狭窄程度＜50％组nSSD、dDSD及dSSD水平低于狭窄程度≥50％组(P＜0.05);狭窄程度＜50％组及狭窄程度≥50％组血压昼夜节律差异具有统计学意义(P＜0.05).结论 急性前循环脑梗死患者的血压变异性与颈动脉粥样硬化斑块密切相关,临床中可通过纠正异常节律,改善患者血压变异性,可起到预防及控制动脉硬化的作用.%Objective To investigate the correlation between blood pressure variability and carotid atherosclerotic plaque in patients with acute anterior circulation cerebral infarction and provide evidence for clinical application.Methods 236 patients with acute cerebral infarction were divided into carotid artery stenosis group (206 cases) and non carotid artery stenosis group (30 cases).According to the degree of carotid artery stenosis,the patients in the carotid artery stenosis group were divided into ＜ 50％ group (carotid artery stenosis more than 50％,142 cases) and stenosis more than ≤ 50％ group (carotid artery stenosis less than 50％,64 cases).The patients were detected with ultrasound examination and ambulatory blood pressure monitoring.Results The nSSD,dDSD and dSSD of stenosis group were significantly higher than that of non-stenosis group (P＜0.05).The circadian rhythm of blood pressure of stenosis group and non-stenosis group existed obvious difference.The difference was statistical significance (P＜0.05).The nSSD,dDSD,dSSD of ＜50 ％ stenosis group were significantly lower than that of ≤ 50％ group (P＜0.05).The degree of circadian rhythm of stenosis ＜50 ％ group and ≤ 50％ group was significant difference (P＜0.05).Conclusion The acute anterior circulation cerebral infarction blood pressure variability and carotid atherosclerosis is closely related to the clinical by correcting the abnormal rhythm.Improving the blood pressure variability can play a role in the prevention and control of atherosclerosis.