季节性血压变异与不同严重程度脑小血管病总负荷评分的相关性分析OA
Correlation between seasonal blood pressure variability and total burden score of cerebral small vessel disease with different severities
目的 探讨季节性血压变异与不同严重程度脑小血管病(CSVD)总负荷评分的相关性.方法 连续纳入CSVD患者,根据头部MRI总负荷评分,分为对照组(CSVD 0分)、轻度组(CSVD 1～2分)、中重度组(CSVD 3～4分),收集患者的一般资料和热季、冷季24 h动态血压监测(ABPM).分析不同季节ABPM参数与CSVD不同程度影像负荷的关系.结果 145例患者中对照组29例、轻度组64例、中重度组52例.轻度组及中重度组在年龄(F=9.721,P=0.001)、热季24 h收缩压(F=6.572,P=0.002)、热季日间收缩压(F=6.460,P=0.002)、热季日间舒张压(F=5.802,P=0.004)、热季夜间收缩压(F=8.508,P<0.001).重度组在热季24 h舒张压(F=4.564,P=0.012)、热季夜间舒张压(F=6.294,P=0.002)、冷季24 h收缩压(F=7.012,P=0.001)、冷季24 h舒张压(F=4.527,P=0.012)、冷季日间收缩压(F=5.708,P=0.004)、冷季日间舒张压(F=3.138,P=0.046)、冷季夜间收缩压(F=9.154,P<0.001)、冷季夜间舒张压(F=8.006,P=0.001)高于对照组.轻度及中重度组在热季及冷季异常血压昼夜节律比率(χ2=13.059,P=0.001)、(χ2=10.091,P=0.006)比率均高于对照组.有序Logistic回归分析提示年龄是CSVD发生的独立危险因素(OR=1.147,95%CI 1.084～1.214),与杓型血压患者相比,热季非杓型血压患者发生的CSVD的风险增加13.282倍(OR=13.282,95%CI 2.379～74.159)、反杓型增加25.569倍(OR=25.569,95%CI 3.061～213.551).结论 年龄越大、热季血压昼夜节律异常比例越高,则CSVD影像负荷评分越重;年龄和热季异常血压昼夜节律是影响CSVD影像负荷的独立危险因素.
Objective To investigate the correlation between seasonal blood pressure(BP)variability and total burden score of cerebral small vessel disease(CSVD)with different severities.Methods The patients with CSVD who were consecu-tively admitted were enrolled,and according to the total burden score based on head MRI,they were divided into control group(CSVD 0 points),mild group(CSVD 1-2 points),and moderate-to-severe group(CSVD 3-4 points).General information was collected from all patients,as well as 24-hour ambulatory blood pressure monitoring(ABPM)during warm and cold seasons.The correlation between ABPM parameters in different seasons and the imaging burden of different severities of CSVD was analyzed.Results A total of 145 patients were enrolled,with 29 patients in the control group,64 in the mild group,and 52 in the moderate-to-severe group.Compared with the control group,the mild group and the moderate-to-severe group had significantly higher age(F=9.721,P=0.001),24-hour systolic blood pressure(SBP)in hot season(F=6.572,P=0.002),daytime SBP in hot season(F=6.460,P=0.002),daytime diastolic blood pressure(DBP)in hot season(F=5.802,P=0.004),nighttime SBP in hot season(F=8.508,P<0.001).Compared with the control group,the moderate-to-severe group had significantly higher levels of 24-hour DBP in hot season(F=4.564,P=0.012),nighttime DBP in hot season(F=6.294,P=0.002),24-hour SBP in cold season(F=7.012,P=0.001),24-hour DBP in cold season(F=4.527,P=0.012),daytime SBP in cold season(F=5.708,P=0.004),daytime DBP in cold season(F=3.138,P=0.046),nighttime SBP in cold season(F=9.154,P<0.001),and night-time DBP in cold season(F=8.006,P=0.001).Compared with the control group,the mild group and the moderate-to-severe group had a significantly higher proportion of patients with abnormal BP circadian rhythm in hot season(χ2=13.059,P=0.001)and cold season(χ2=10.091,P=0.006).The ordinal logistic regression analysis showed that age(OR=1.147,95%CI 1.084-1.214)was an independent risk factor for CSVD,and compared with the patients with dipper-type blood pressure in hot season,the patients with non-dipper blood pressure pattern had a risk of CSVD increased by 13.282 times(OR=13.282,95%CI 2.379-74.159),while those with reverse-dipper blood pressure pattern had a risk of CSVD increased by 25.569 times(OR=25.569,95%CI 3.061-213.551).Conclusion The imaging burden score of CSVD increases with the increase in age and the proportion of abnormal circadian blood pressure pattern in hot season,and both age and abnormal circadian blood pressure pattern in hot season are independent risk factors for the imaging bur-den of CSVD.
刘欣;王丽娟;刘荧;崔明愚;李皓;魏欣
北京市中关村医院神经内科,北京 100190北京市中关村医院神经内科,北京 100190北京市中关村医院神经内科,北京 100190北京市中关村医院神经内科,北京 100190北京市中关村医院神经内科,北京 100190北京市中关村医院神经内科,北京 100190
医药卫生
脑小血管病动态血压血压变异性危险因素磁共振成像
Cerebral small vessel diseaseAmbulatory blood pressureBlood pressure variabilityRisk fac-torsMagnetic resonance imaging
《中风与神经疾病杂志》 2026 (1)
10-14,5
首都卫生发展科研专项(首发2022-3-7041)
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