{"title":"急性缺血性卒中患者24小时动态血压变异性与脑血管疾病负担的关系","authors":"Jun Shen, Lu Yang, Ziwei Xu, Wenshi Wei","doi":"10.1155/2022/3769577","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study is aimed at investigating the association between the twenty-four-hour ambulatory blood pressure variability monitoring (ABPM) and cerebral small vessel disease (cSVD) burden in acute ischemic stroke (AIS) patients.</p><p><strong>Methods: </strong>115 AIS patients with demographics, vascular risk factors, 24 h ABPM, and brain magnetic resonance imaging (MRI) were retrospectively enrolled. 3.0 T MRI was used to assess cSVD burden by combining four MRI markers including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), perivascular spaces (PVS), and lacunes. Correlation analysis was conducted to detect whether ABPM was associated with cSVD burden in AIS patients.</p><p><strong>Results: </strong>115 AIS patients with mean age 68.77 ± 10.26 years and 75.7% male were enrolled in this study. 112 AIS patients (97.4%) had at least one cSVD marker. Spearman correlation analysis indicated that hypertension was positively correlated with cSVD burden (<i>ρ</i> = 0.21, <i>P</i> = 0.07). High-density lipoprotein (HDL) was negatively correlated with cSVD burden (<i>ρ</i> = -0.21, <i>P</i> = 0.02). Blood pressure variability such as 24 h mean SBP (<i>ρ</i> = 0.23, <i>P</i> = 0.01), day mean SBP (<i>ρ</i> = 0.23, <i>P</i> = 0.01), and night mean SBP (<i>ρ</i> = 0.20, <i>P</i> = 0.04) was positively correlated with higher cSVD burden. Ordinal logistic regression analysis demonstrated that higher 24 h SBP SD and day mean SBP were independent risk factors for cSVD after controlling for other confounders.</p><p><strong>Conclusions: </strong>Higher BPV was significantly related to total cSVD burden in AIS patients. 24 h SBP SD and day mean SBP were independent risk factors for cSVD burden in AIS patients but not DBP or DBP variability.</p>","PeriodicalId":50733,"journal":{"name":"Behavioural Neurology","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9596265/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between Twenty-Four-Hour Ambulatory Blood Pressure Variability and Cerebral Small Vessel Disease Burden in Acute Ischemic Stroke.\",\"authors\":\"Jun Shen, Lu Yang, Ziwei Xu, Wenshi Wei\",\"doi\":\"10.1155/2022/3769577\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study is aimed at investigating the association between the twenty-four-hour ambulatory blood pressure variability monitoring (ABPM) and cerebral small vessel disease (cSVD) burden in acute ischemic stroke (AIS) patients.</p><p><strong>Methods: </strong>115 AIS patients with demographics, vascular risk factors, 24 h ABPM, and brain magnetic resonance imaging (MRI) were retrospectively enrolled. 3.0 T MRI was used to assess cSVD burden by combining four MRI markers including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), perivascular spaces (PVS), and lacunes. Correlation analysis was conducted to detect whether ABPM was associated with cSVD burden in AIS patients.</p><p><strong>Results: </strong>115 AIS patients with mean age 68.77 ± 10.26 years and 75.7% male were enrolled in this study. 112 AIS patients (97.4%) had at least one cSVD marker. Spearman correlation analysis indicated that hypertension was positively correlated with cSVD burden (<i>ρ</i> = 0.21, <i>P</i> = 0.07). High-density lipoprotein (HDL) was negatively correlated with cSVD burden (<i>ρ</i> = -0.21, <i>P</i> = 0.02). Blood pressure variability such as 24 h mean SBP (<i>ρ</i> = 0.23, <i>P</i> = 0.01), day mean SBP (<i>ρ</i> = 0.23, <i>P</i> = 0.01), and night mean SBP (<i>ρ</i> = 0.20, <i>P</i> = 0.04) was positively correlated with higher cSVD burden. Ordinal logistic regression analysis demonstrated that higher 24 h SBP SD and day mean SBP were independent risk factors for cSVD after controlling for other confounders.</p><p><strong>Conclusions: </strong>Higher BPV was significantly related to total cSVD burden in AIS patients. 24 h SBP SD and day mean SBP were independent risk factors for cSVD burden in AIS patients but not DBP or DBP variability.</p>\",\"PeriodicalId\":50733,\"journal\":{\"name\":\"Behavioural Neurology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2022-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9596265/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Behavioural Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/3769577\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Behavioural Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2022/3769577","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨急性缺血性脑卒中(AIS)患者24小时动态血压变异性监测(ABPM)与脑血管病(cSVD)负担的关系。方法:回顾性分析115例AIS患者的人口统计学特征、血管危险因素、24 h ABPM和脑磁共振成像(MRI)。3.0 T MRI通过结合白质高信号(WMHs)、脑微出血(CMBs)、血管周围间隙(PVS)和腔隙(lacunes)四种MRI标记来评估cSVD负担。通过相关分析检测ABPM是否与AIS患者的cSVD负担相关。结果:115例AIS患者入组,平均年龄68.77±10.26岁,男性75.7%。112例AIS患者(97.4%)至少有一种cSVD标志物。Spearman相关分析显示高血压与cSVD负担呈正相关(ρ = 0.21, P = 0.07)。高密度脂蛋白(HDL)与cSVD负荷呈负相关(ρ = -0.21, P = 0.02)。血压变异性如24 h平均收缩压(ρ = 0.23, P = 0.01)、白天平均收缩压(ρ = 0.23, P = 0.01)和夜间平均收缩压(ρ = 0.20, P = 0.04)与较高的cSVD负担呈正相关。有序逻辑回归分析表明,在控制其他混杂因素后,较高的24小时收缩压SD和日平均收缩压是cSVD的独立危险因素。结论:高BPV与AIS患者总cSVD负担显著相关。24 h收缩压、SD和日均收缩压是AIS患者心血管疾病负担的独立危险因素,而不是舒张压或舒张压变异性。
Association between Twenty-Four-Hour Ambulatory Blood Pressure Variability and Cerebral Small Vessel Disease Burden in Acute Ischemic Stroke.
Objective: This study is aimed at investigating the association between the twenty-four-hour ambulatory blood pressure variability monitoring (ABPM) and cerebral small vessel disease (cSVD) burden in acute ischemic stroke (AIS) patients.
Methods: 115 AIS patients with demographics, vascular risk factors, 24 h ABPM, and brain magnetic resonance imaging (MRI) were retrospectively enrolled. 3.0 T MRI was used to assess cSVD burden by combining four MRI markers including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), perivascular spaces (PVS), and lacunes. Correlation analysis was conducted to detect whether ABPM was associated with cSVD burden in AIS patients.
Results: 115 AIS patients with mean age 68.77 ± 10.26 years and 75.7% male were enrolled in this study. 112 AIS patients (97.4%) had at least one cSVD marker. Spearman correlation analysis indicated that hypertension was positively correlated with cSVD burden (ρ = 0.21, P = 0.07). High-density lipoprotein (HDL) was negatively correlated with cSVD burden (ρ = -0.21, P = 0.02). Blood pressure variability such as 24 h mean SBP (ρ = 0.23, P = 0.01), day mean SBP (ρ = 0.23, P = 0.01), and night mean SBP (ρ = 0.20, P = 0.04) was positively correlated with higher cSVD burden. Ordinal logistic regression analysis demonstrated that higher 24 h SBP SD and day mean SBP were independent risk factors for cSVD after controlling for other confounders.
Conclusions: Higher BPV was significantly related to total cSVD burden in AIS patients. 24 h SBP SD and day mean SBP were independent risk factors for cSVD burden in AIS patients but not DBP or DBP variability.
期刊介绍:
Behavioural Neurology is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on various diseases and syndromes in behavioural neurology. The aim of the journal is to provide a platform for researchers and clinicians working in various fields of neurology including cognitive neuroscience, neuropsychology and neuropsychiatry.
Topics of interest include:
ADHD
Aphasia
Autism
Alzheimer’s Disease
Behavioural Disorders
Dementia
Epilepsy
Multiple Sclerosis
Parkinson’s Disease
Psychosis
Stroke
Traumatic brain injury.