长时血压变异性与脑白质病变的相关性研究

目的探讨长时血压变异性(blood pressure variability,BPV)与脑白质病变(white matter lesions,WML)发病及严重程度的关系。方法选取符合条件的136例住院患者作为研究对象,每(20±10)d随诊间测量血压,随访12 m,采用改良Scheltens量表评定WML严重程度;分析两组患者的长时血压变异性指标(平均收缩压、平均舒张压、收缩压变异系数、舒张压变异系数、收缩压标准差、舒张压标准差等)。结果 (1)WML组患者平均收缩压、平均舒张压、收缩压变异系数、舒张压变异系数、收缩压标准差、舒张压标准差分别为(135.71±19.84)mmHg、(79.22±15.36)mm Hg、9.08±2.10、11.86±1.49、13.81±3.52、10.12±2.53,高于对照组的(124.88±17.96)mm Hg、(74.33±7.68)mm Hg、7.06±1.85、10.47±1.29、11.17±2.13、9.80±2.45,差异均有统计学意义(P<0.05);(2)WML组改良Scheltens量表评分,不同程度患者之间比较,收缩压水平、收缩压变异系数、收缩压标准差差异有统计学意义(P<0.05)。结论年龄、高血压、BPV增大是WML的危险因素,长时BPV对WML的发生及进展有一定的预测作用。

The correlation of blood pressure variability in the pathogenesis and progression of white matter lesions

Objective To study the correlation of long time blood pressure variability(BPV)on the pathogenesis and severity of white matter lesions(WML).Methods The patients(n=136)were chosen from Mar.2015 to Sep.2015 in our hospital as the research objects,blood pressures was were measured visit-to-visit every(20±10)days,followed up for 12 months.Analysis two groups with long time blood pressure variability index——systolic blood pressure(SBP),diastolic blood pressure(DBP),coefficient of variation of SBP(SBPV)and coefficient of variation of DBP(DBPV),the standard deviation of SBP(SSD),the standard deviation of DBP(DSD).Results (1)patients in WML group,SBP,DBP,SBPV and DBPV respectively(135.71+19.84)mmHg,(79.22+15.36)mmHg,9.08+2.10,11.86+1.49,13.81±3.52,10.12±2.53,patients in control group respectively(124.88+17.96)mmHg,(74.33+7.68)mmHg,7.06+1.85,10.47+1.29,11.17±2.13,9.80±2.45;SBP,DBP,SBPV and DBPV in WML group was significantly higher than control group(P<0.05);(2)WML group modified Scheltens scale score was statistically significant,the difference between patients with different degree,SBP,SBPV,SSD was statistically significant(P<0.05).Conclusion Age,blood pressure,the increase of BPV is the risk factors of WML,long time development and progression of BPV to WML forecast.