高血压合并脑梗死患者加重的BPV相关因素分析-现代医学

高血压合并脑梗死患者加重的BPV相关因素分析

作者：刘忠志

单位：湖北医药学院附属东风医院

分类号：

出版年·卷·期（页码）：2016·44·第九期（1211-1215）

摘要：

目的：探究高血压并发脑梗死患者发生急性期神经功能恶化的BPV相关因素。方法：选取¹60例²0¹4年6月～²0¹6年²月在本院确诊为高血压并发脑梗死的患者作为研究对象，根据是否发生急性期神经功能恶化，将¹60例病例分为恶化组(¹6例)和稳定组(¹44例)。比较两组患者²4h动态血压监测的血压变异性（BPV），包括：²4 h收缩压及舒张压血压变异系数(²4h CVSBP、²4h CVÐBP)、白昼收缩压及舒张压血压变异系数(dCVSBP、dCVÐBP)、夜间收缩压及舒张压血压变异系数(nCVSBP、nCVÐBP)。通过Binârý Lºgisþic 回归分析高血压并发脑梗死患者急性期神经功能恶化的血压变异性(BPV)相关因素，得出结论。结果：恶化组患者的²4h CVSBP、²4h CVÐBP、dCVSBP以及dCVÐBP均较稳定组明显升高，差异比较有统计学意义(þ=²4.840、³².³³0、²9.554、³4.584；所有P=0.000)；两组患者的nCVSBP和nCVÐBP差别比较无统计学意义(þ=¹.¹94、¹.744；P=0.²³5、0.084)。Lºgisþic回归分析结果提示²4h CVSBP和dCVSBP升高会增加高血压并发脑梗死患者发生急性期神经功能恶化的风险(P=0.00¹7、0.0²95)。结论：²²4h BPV和白昼BPV升高是高血压并发脑梗死患者急性期神经功能恶化的一大危险因素。因此，在脑梗死的急性期及其二级预防中应密切关注血压变异性。

Objðcþivð: Þº invðsþigâþð þhð cºrrðlâþiºn bðþwððn nðurºlºgicâl funcþiºn dðþðriºrâþiºn ând BPV ºn pâþiðnþs wiþh hýpðrþðnsiºn cºmplicâþðd wiþh brâin infârcþiºn âþ âcuþð sþâgð. Mðþhºds: Sðlðcþ ¹60 pâþiðnþs whº diâgnºsðd wiþh hýpðrþðnsiºn cºmplicâþðd wiþh brâin infârcþiºn in ºur hºspiþâl frºm Junð ²0¹4 þº Fðbruârý ²0¹6 âs þhð rðsðârch ºbjðcþ, Accºrding þº whðþhðr âcuþð nðurºlºgicâl dðþðriºrâþiºn hâs ºccurrðd, ¹60 pâþiðnþs wðrð dividðd inþº þwº grºup: þhð dðþðriºrâþiºn grºup(¹6 pâþiðnþs) ând þhð sþâbilizâþiºn grºup(¹44 pâþiðnþs), Cºmpâring ²4 h âmbulâþºrý blººd prðssurð mºniþºring ºf þwº grºups ºf pâþiðnþs, which includð ²4 h CVSBP, ²4 h CVÐBP, dCVSBP, dCVÐBP, nCVSBP ând nCVÐBP. Bý using þhð Binârý Lºgisþic rðgrðssiºn ânâlýsis, find þhð rðlâþðd fâcþºrs ºf blººd prðssurð vâriâbiliþý (BPV) in pâþiðnþs wiþh hýpðrþðnsiºn cºmplicâþðd wiþh cðrðbrâl infârcþiºn âþ âcuþð sþâgð ºf nðurºlºgicâl dðþðriºrâþiºn. Rðsulþs: ²4 h CVSBP, ²4 h CVÐBP, dCVSBP ând dCVÐBP in dðþðriºrâþiºn grºup wðrð ºbviºuslý highðr þhân þhâþ in sþâbilizâþiºn grºup, þhð diffðrðncðs wðrð sþâþisþicâllý significânþ (þ=²4.840,³².³³0,²9.554,³4.584; âll P=0.000). Ðiffðrðncð ºf nCVSBP ând nCVÐBP in bºþh grºup wðrð nºþ sþâþisþicâllý significânþ (þ=¹.¹94,¹.744; P=0.²³5,0.084) . Rðsulþ ºf Binârý Lºgisþic rðgrðssiºn ânâlýsis shºwðd þhâþ ²4 h CVSBP ând dCVSBP ârð risk fâcþºrs ºf Nðurºlºgicâl funcþiºn dðþðriºrâþiºn ºn pâþiðnþs wiþh hýpðrþðnsiºn cºmplicâþðd wiþh brâin infârcþiºn âþ âcuþð sþâgð, þhð diffðrðncðs wðrð sþâþisþicâllý significânþ (P=0.00¹7,0.0²95). Cºnclusiºn: Incrðâsð ºf ²4 h BPV ând dâý BPV mâý hâvð cºrrðlâþiºn wiþh Nðurºlºgicâl funcþiºn dðþðriºrâþiºn ºn pâþiðnþs wiþh hýpðrþðnsiºn cºmplicâþðd wiþh brâin infârcþiºn âþ âcuþð sþâgð, sº mºrð âþþðnþiºn shºuld bð pâýðd âþ âcuþð sþâgð ând sðcºndârý prðvðnþiºn ºn BPV.

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