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目的探讨24h动态血压节律变化与脑白质疏松发生的关系。方法总结2006年1月至2008年7月因急性腔隙性脑梗死住院的87例患者的资料,将头颅磁共振(MRI)所见脑白质疏松按照Fazekas评分标准分为无/轻度组(0～1分)和中重度组(2～3分);采用无创性携带式动态血压监测仪进行动态血压监测和Logistic回归分析。结果无/轻度组40例,中重度组47例。将年龄、糖尿病等纳入多因素Binarylogistic回归分析提示,24h平均DBP(OR=1.077,95%CI:1.001～1.158,P=0.044)、白昼平均SBP(OR=1.091,95%CI:1.020～1.167,P=0.011)、白昼平均DBP(OR=1.176,95%CI:1.016～1.360,P=0.029)、夜间SBP下降百分比(OR=0.348,95%CI:0.180～0.673,P=0.002)是LA发生、发展的危险因素。结论脑白质疏松患者血压异常增高及昼夜节律消失可能参与白质疏松的发病机制。
Objective To investigate the relationship between the change of 24h ambulatory blood pressure rhythm and the occurrence of leukoaraiosis. Methods The data of 87 hospitalized patients with acute lacunar infarction from January 2006 to July 2008 were summarized. The leukoaraiosis of brain in MRI was divided into no / mild group according to Fazekas scale 0 to 1) and moderate to severe group (2 to 3). Ambulatory blood pressure monitoring and logistic regression analysis were performed using a noninvasive portable ambulatory blood pressure monitor. Results no / mild group of 40 cases, moderate and severe group of 47 cases. Binary logistic regression analysis of age, diabetes mellitus and other factors suggested that 24h average DBP (OR = 1.077,95% CI: 1.001-1.1558, P = 0.044), daytime SBP (OR = 1.091, 95% CI: 1.020-1.167, P = 0.011), daytime mean DBP (OR = 1.176, 95% CI: 1.016-1.360, P = 0.029), nighttime SBP decline (OR = 0.348,95% CI: 0.180-0.673, P = 0.002) , The development of risk factors. Conclusion The abnormal increase of blood pressure and disappearance of circadian rhythm in patients with leukoaraiosis may be involved in the pathogenesis of leukoaraiosis.