高血压合并急性脑梗死患者的动态血压特征

目的研究高血压合并急性脑梗死患者的动态血压特征。方法选取2011年10月～2013年6月在河北联合大学附属医院住院的高血压患者262例,按照是否合并急性脑梗死或无症状脑梗死,分为急性脑梗死组(n=86),无症状脑梗死组(n=82),非脑梗死组(n=94),比较三组24h平均收缩压、白昼平均收缩压、夜间平均收缩压、24h平均舒张压、白昼舒张压、夜间舒张压、白昼收缩压负荷、夜间收缩压负荷、白昼舒张压负荷、夜间舒张压负荷情况。结果与非脑梗死组比较,急性脑梗死组患者的24h平均收缩压、白昼平均收缩压、夜间平均收缩压均增高,差异有统计学意义(P均0.05)。无症状脑梗死组与非脑梗死组及急性脑梗死组患者24h平均收缩压、白昼平均收缩压、夜间平均收缩压比较,无显著统计学差异(P均0.05)。与非脑梗死组比较,无症状脑梗死组和急性脑梗死组患者的24h平均舒张压、白昼平均舒张压、夜间平均舒张压均无显著统计学差异(P0.05)。与非脑梗死组患者比较,急性脑梗死组、无症状脑梗死组患者的白昼收缩压负荷、夜间收缩压负荷、白昼舒张压负荷、夜间舒张压负荷均显著增高,差异均有统计学意义(P均0.05)结论临床治疗中,对于无症状性脑梗死患者降压时以降低血压负荷为主,而出现急性脑梗死并发症时应降低收缩压兼顾降低血压负荷。

Characteristics of ambulatory blood pressure in patients with hypertension complicating acute cerebral infarction

Objective To study the characteristics of ambulatory blood pressure in the patients with hypertension complicating acute cerebral infarction （ACI）. Methods The patients （n=262） were chosen from the Affiliated Hospital of Hebei United University from Oct. 2011 to Jun. 2013, and divided into ACI group （n=86）, asymptomatic ACI group （n=82） and non-ACI group （n=94）. The changes of 24 h mean systolic blood pressure （MSBP）, daytime MSBP, nighttime MSBP, 24 h mean diastolic blood pressure （MDBP）, daytime MDBP, nighttime MDBP, daytime systolic blood pressure load （SBPL）, nighttime SBPL, daytime diastolic blood pressure load （DBPL） and nighttime DBPL were compared in 3 groups. Results Compared with non-ACI group, 24 h MSBP, daytime MSBP and nighttime MSBP increased in ACI group （all P〈0.05）, which had no statistical difference compared between asymptomatic ACI group and non-ACI group or ACI group （all P〉0.05）. Compared with non-ACI group, 24 h MDBP, daytime MDBP and nighttime MDBP had no statistical difference in asymptomatic ACI group and ACI group （P〉0.05）. Compared with non-ACI group, daytime SBPL, nighttime SBPL, daytime DBPL and nighttime DBPL increased significantly in ACI group and asymptomatic ACI group （all P〈0.05）. Conclusion In clinical treatment, decreasing blood pressure load is main anti-hypertension therapy in the patients with asymptomatic ACI, and reducing SBP and blood pressure load is important in the patients with complications of ACI.