血压变异性和颈动脉斑块与脑梗死分型的相关性研究

摘要

目的 探讨血压变异性(blood pressure variability,BPV)和颈动脉斑块与急性脑梗死(oxforshire community stroke project,OCSP)分型的关系.方法 236例急性脑梗死患者根据OCSP分型分为完全前循环梗死(TACI)组26例、部分前循环梗死(PACI)组76例、后循环梗死(POCI)组42例和腔隙性梗死(LACI)组92例.进行动态血压监测,计算收缩压、舒张压标准差及血压夜间下降率,同时应用彩色多普勒超声仪检测脑梗死患者颈动脉有无斑块及斑块性质.结果 TACI、POCI组日间收缩压标准差(dSSD)、日间舒张压标准差(dDSD)和夜间收缩压标准差(nSSD)高于LACI组,杓型节律者比例低于LACI组,差异有统计学意义(P＜0.05)；TACI、POCI亚型组颈动脉斑块出现率及不稳定斑块比率高于LACI亚型组,差异有统计学意义(P＜0.05).结论 血压变异性及颈动脉斑块及其性质与急性脑梗死OCSP分型中TACI、POCI亚型有关.%Objective To explore the rela tian ship of blood pressure variability (BPV) and carotid artery plagues with acute cerebral infarction by oxforshire community stroke project (OCSP) system.Methods Based on OCSP subtyping system,236 cases of acute cerebral infarction were classified into TACA (26 cases),PACI (76 cases),POCI (42 cases) and LACI (92 cases).All the patients were monitored for dynamic blood pressure,based on which night systolic standard deviation (nSSD),daytime systolic standard deviation (dSSD) and daytime diastolic standard deviation (dDSD) were calculated.The patients were also screened by color ultrasonography for the existence and characteristics of the plagues in carotid artery.Results The dSSD,dDSD and nSSD in TACI and POCI groups were higher than that of LACI group,while there were lower in dipper rhythm than that of LACI group.The differences were significant (P ＜0.05).Both incidence of plagues and unstable plagues in carotid artery were higher in TACI and POCI groups than those in LACI group (P ＜ 0.05).Conclusion Blood pressure variability and the nature of plagues in carotid artery were correlated to the TACI and POCI subgroups by OCSP classification system.