血压变异性与老年无症状脑血管损害的相关性研究

目的 探讨老年原发性高血压患者无症状性腔隙性脑梗死发病与血压变异性（BPV）的关系.方法 根据颅脑MRI的结果,将160例患者分为高血压合并腔隙性脑梗死组96例和单纯性高血压组64例,监测24h动态血压,比较两组24 h平均收缩压变异系数（24hSBPV）、24h平均舒张压变异系数（24 h DBPV）、白昼平均收缩压变异系数（dSBPV）、夜间平均收缩压变异系数（nSBPV）、白昼平均舒张压变异系数（dDBPV）、夜间平均舒张压变异系数（nDBPV）、晨峰收缩压及舒张压的标准差（SD）和变异系数（CV）.结果 高血压合并腔隙性脑梗死组24 h SBPV、dSBPV、nSBPV、24 h DBPV、dDBPV、nDBPV均高于单纯性高血压组（0.15±0.03比0.11±0.02、0.14±0.02比0.10±0.03、0.14±0.03比0.10±0.08、0.13±0.08比0.11±0.04、0.14±0.02比0.11±0.07、0.14±0.05比0.09±0.02）,差异有统计学意义（P＜0.05）.高血压合并腔隙性脑梗死组晨峰收缩压-SD、晨峰舒张压-SD、晨峰收缩压-CV、晨峰舒张压-CV均高于单纯性高血压组[（15.37±4.55） mmHg（1 mmHg=0.133 kPa）比（13.53±2.26） mmHg、（13.64±4.95） mmHg比（9.80±3.46） mmHg、0.141±0.048比0.113±0.037、0.145±0.056比0.105±0.036],差异有统计学意义（P＜0.05）.结论 高血压合并腔隙性脑梗死患者BPV水平,尤其是晨峰BPV水平高于单纯高血压患者,BPV增大是脑梗死发病的重要危险因素之一.

Study on the relationship between blood pressure variability and senile asymptomatic cerebrovascular damage

Objective To explore the relationship between asymptomatic lacunar cerebral infarction and blood pressure variability （BPV） in senile patients with essential hypertension.Methods According to the results of the cranial magnetic resonance imaging （MRI）,160 patients were divided into two groups：96 cases of hypertension combined with lacunar cerebral infarction group and 64 cases of simple hypertension group.Their levels and variability blood pressure were investigated by 24 hours ambulatory blood pressure monitoring.All markers included 24 h average systolic blood pressure variation （24 h SBPV）,24 h average diastolic blood pressure variation （24 h DBPV）,the day average systolic blood pressure variation （dSBPV）,the night average systolic blood pressure variation （nSBPV）,the day average diastolic blood pressure variation （dDBPV）,the night average diastolic blood pressure variation （nDBPV）,the standard deviation （SD）and variable coefficient （CV） of morning peak systolic blood pressure and diastolic blood pressure.Results 24 h SBPV,dSBPV,nSBPV,24 h DBPV,dDBPV,nDBPV was increased significantly in hypertension combined with lacunar cerebral infarction group compared with those in simple hypertension group （0.15±0.03 vs.0.11 ± 0.02,0.14 ± 0.02 vs.0.10 ± 0.03,0.14 ± 0.03 vs.0.10 ± 0.08,0.13 ± 0.08 vs.0.11 ±0.04,0.14 ±0.02 vs.0.11 ±0.07,0.14 ±0.05 vs.0.09 ±0.02）,and there was significant difference （P ＜ 0.05）.SD and CV of morning peak systolic blood pressure and diastolic blood pressure in hypertension combined with lacunar cerebral infarction group was higher than that in simple hypertension group [（15.37 ±4.55） mmHg （1 mmHg =0.133 kPa） vs.（13.53 ±2.26） mmHg,（13.64 ±4.95） mmHg vs.（9.80 ± 3.46） mmHg,0.141 ± 0.048 vs.0.113 ± 0.037,0.145 ± 0.056 vs.0.105 ± 0.036],and there was significant difference（P ＜ 0.05）.Conclusion The BPV,especially morning blood pressure surge BPV are increased significantly in the hypertension combined wi