出血性脑卒中与缺血性脑卒中患者血压变异性特点分析

摘要

Objective To analyze the clinical characteristics of blood pressure variability in patients with hemorrhagic stroke or ischemic stroke.Methods From January 2015 to September 2017,a total of 211 patients with stroke were selected in the Department of Neurology,Xiangyang Central Hospital Affiliated to Hubei University of Arts and Sciences,thereinto 84 patients with hemorrhagic stroke were severed as A group,the other 127 patients with ischemic stroke were selected as B group;meanwhile a total of 80 healthy people admitted to this hospital for physical examination were selected as control group.General information,laboratory examination results,indicators of dynamic blood pressure and blood pressure variability were compared in the three groups.Results No statistically significant differences of age,gender or smoking history was found in the three groups(P>0.05);incidence of hypertension,BMI,FPG,TC and LDL in A group and B group were statistically significantly higher than those in control group,while HDL in A group and B group was statistically significantly lower than that in control group,respectively(P<0.05);TG in B group was statistically significantly higher than that in control group,while HDL in B group was statistically significantly lower than that in A group(P<0.05).No statistically significant differences of 24-hour DBP or daytime DBP was found in the three groups(P>0.05);24-hour SBP,daytime SBP and nighttime DBP in A group and B group were statistically significantly higher than those in control group,meanwhile daytime DBP in B group was statistically significantly higher than that in control group(P<0.05).No statistically significant differences of standard deviation of 24-hour DBP,standard deviation of daytime SBP,standard deviation of daytime DBP,standard deviation of nighttime DBP or variable coefficient of DBP was found in the three groups(P>0.05);standard deviation of 24-hour SBP,standard deviation of daytime SBP,variable coefficient of SBP and morning blood pressure surge in A group and B group were statistically significantly higher than those in control group,while variable coefficient of SBP and morning blood pressure surge in B group were statistically significantly lower than those in A group(P<0.05).Conclusion Abnormal blood pressure variability is existing in patients with stroke,and compared with patients with ischemic stroke,variable coefficient of SBP and morning blood pressure surge are significantly higher in patients with hemorrhagic stroke.%目的 分析出血性脑卒中与缺血性脑卒中患者血压变异性特点.方法 选取2015年1月—2017年9月湖北文理学院附属襄阳市中心医院神经内科收治的脑卒中患者211例,其中出血性脑卒中患者84例(A组)和缺血性脑卒中患者127例(B组);另选取同期体检健康者80例作为对照组.比较3组受试者一般资料、实验室检查指标、动态血压指标及血压变异性指标.结果 3组受试者年龄、性别、吸烟史比较,差异无统计学意义(P>0.05);A组和B组患者高血压发生率、体质指数、空腹血糖及总胆固醇、低密度脂蛋白水平高于对照组,高密度脂蛋白水平低于对照组(P<0.05);B组患者三酰甘油水平高于对照组,高密度脂蛋白水平低于A组(P<0.05).3组受试者24 h舒张压和白天舒张压比较,差异无统计学意义(P>0.05);A组和B组患者24 h收缩压、白天收缩压、夜间收缩压高于对照组,B组患者夜间舒张压高于对照组(P<0.05).3组受试者24 h舒张压标准差、白天收缩压标准差、白天舒张压标准差、夜间舒张压标准差及舒张压变异系数比较,差异无统计学意义(P>0.05);A组和B组患者24 h收缩压标准差、夜间收缩压标准差、收缩压变异系数及血压晨峰高于对照组,B组患者收缩压变异系数和血压晨峰低于A组(P<0.05).结论 脑卒中患者存在血压变异性异常,与缺血性脑卒中患者相比,出血性脑卒中患者收缩压变异系数和血压晨峰更高.