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目的探讨动态血压各参数与高血压患者缺血性脑卒中发生的相关关系。方法对450例高血压病患者进行动态血压监测,随访观察3年,根据是否发生缺血性脑卒中分为脑卒中组(IS组,n=82)和无卒中组(NS组,n=354)。用Logistic回归分析确定有无脑卒中者的血压变化。结果 IS组的血压昼夜节律消失百分率、与收缩压(SBP)相关各指标均显著高于NS组(P<0.01),24h平均舒张压(DBP)、日平均DBP、日DBP负荷显著低于NS组(P<0.01);血压昼夜节律消失、与SBP相关各指标与缺血性脑卒中呈正相关关系,24h平均DBP、日平均DBP、日DBP负荷与缺血性脑卒中呈负相关关系。结论血压昼夜节律消失、24h平均DBP、日平均DBP、日DBP负荷降低、与SBP相关各指标对高血压患者发生缺血性脑卒中有相关性。
Objective To investigate the relationship between ambulatory blood pressure parameters and ischemic stroke in hypertensive patients. Methods 450 patients with essential hypertension were monitored by ambulatory blood pressure and were followed up for 3 years. According to the incidence of ischemic stroke, they were divided into stroke group (n = 82) and non-stroke group (n = 354) ). Logistic regression analysis was used to determine the changes in blood pressure in stroke-free subjects. Results The percentage of disappearance of circadian rhythm of blood pressure and systolic blood pressure (SBP) in IS group were significantly higher than those in NS group (P <0.01). The mean diastolic blood pressure (DBP), daily average DBP and daily DBP load in IS group were significantly lower than those in NS group (P <0.01). The circadian rhythm of blood pressure disappeared. The indexes related to SBP were positively correlated with ischemic stroke. The average DBP, daily average DBP, daily DBP load and ischemic stroke were negatively correlated. Conclusion The circadian rhythm of blood pressure disappeared, mean DBP, average daily DBP and daily DBP load decreased. The SBP-related indexes were correlated with ischemic stroke in hypertensive patients.