老年原发性高血压病人血压变异性与脑白质疏松的相关性研究

目的:探讨老年原发性高血压病人的血压变异性与脑白质疏松症（leukoaraiosis，LA）的关系。方法:选取老年原发性高血压病人102例，根据MRI的结果分为LA组75例及非LA组27例，并对LA组按照Fazekas量表对脑白质病变程度评估分为轻度LA组23例，中度LA组27例和重度LA组25例。采用无创性便携式血压监测仪监测病人24 h血压变化，比较2组病人血脂指标、高血压病程、24h、日间及夜间收缩压（SBP）和舒张压（DBP）及血压变异性（BPV）。结果:2组病人年龄、性别、高血压病程、血清 TC、TG、LDL-C水平，差异无统计学意义（P>0.05）。LA组病人 24 h SBP 和 DBP、日间SBP 和 DBP、夜间 SBP 和 DBP 均高于非LA组 （P<0.05~P<0.01）。LA组病人24 h SBPV和DBPV、日间SBPV和DBPV、夜间SBPV和DBPV均明显高于非LA组（P<0.01）。不同程度LA组间BPV差异有统计学意义（P<0.01）。重度LA组高于轻度LA组（P<0.05~P<0.01），且重度LA组的日间平均收缩压变异性高于中度LA组（P<0.05），中度LA组夜间平均收缩压变异性明显高于轻度LA组（P<0.01）。结论:老年原发性高血压病人的血压变异性与LA的发生及严重程度有关。

Study on the relationship between blood pressure variability and leukoaraiosis in elderly patients with essential hypertension

Objective:To investigate the relationship between blood pressure variability and leukoaraiosis(LA) in elderly patients with essential hypertension.Methods:A total of 102 elderly patients with essential hypertension were divided into the LA group(75 cases) and Non-LA(27 cases) according to the MRI imaging.According to the Fazekas scale,the LA group were subdivided into the mild LA group(23 cases),moderate LA group(27 cases) and severe LA group(25 cases) according to the LA lesions.Non-invasive portable blood pressure monitor was used to monitor the 24h blood pressure.The blood lipid index,hypertension course,24 h SBP,daytime SBP,nighttime SBP,24 h DBP,daytime DBP and nighttime DBP and blood pressure variability between two groups were compared.Results:The differences of the age,sex,hypertension course,serum levels of TC,TG and LDL-C between the two groups were not statistically significant(P>0.05).The 24 h SBP and DBP,daytime SBP and DBP,and nighttime SBP and DBP in LA group were higher than those in Non-LA group(P<0.05 to P<0.01).The 24 h SBPV and DBPV,daytime SBPV and DBPV and nighttime SBPV and DBPV in LA group were higher than those in Non-LA group(P<0.05 to P<0.01).The difference of the BPV among LA subgroup was statistically significant(P<0.01).The BPV in severe group was higher than that in mild LA group(P<0.01).The average daytime systolic blood pressure variability in severe group was higher than that in moderate LA group(P<0.05),and the average nighttime systolic blood pressure variability in moderate group was higher than that in mild LA group(P<0.01).Conclusions:The blood pressure variability of elderly patients with essential hypertension is related to the occurrence and severity of LA.