CAJ | 학술논문

目的探讨血压波动对老年男性脑梗死发生的影响.方法 1527例患有动脉硬化的老年(年龄＞65岁)男性患者,所有患者监测动态血压,根据有无脑梗死将入选患者分为2组:脑梗死组(607例)和非脑梗死组(920例),用数学平滑曲线方法先将每一个体24 h血压数据进行分析,再描绘出一条适合个体血压变化趋势的曲线,计算实际血压值与该趋势曲线相应位置所形成差值的标准差即为血压波动值,然后比较2组血压波动的情况.结果脑梗死组中24 h的收缩压波动值明显高于非脑梗死组[(8.4±2.2)与(8.0±2.0)mm Hg,t=-2.909,P＜0.01];其中自昼收缩压血压波动明显升高[(8.2±2.2)与(7.8±2.1)mm Hg,t=-2.969,P＜0.01];而夜间收缩压波动2组差异无统计学意义[(8.9±3.9)与(8.7±3.7)mm Hg,P＞0.05];各阶段舒张期血压波动差异无统计学意义[24 h舒张压波动值(5.5±3.8)与(5.5±1.5)mm Hg,P＞0.05;白昼舒张压波动值(5.4±1.5)与(5.3±1.4)mm Hg,P＞0.05;夜间舒张压波动值(6.1±2.7)与(6.1±2.6)mm Hg,P＞0.05].结论在老年男性动脉硬化相关疾病患者中,脑梗死的发生与白昼收缩压的波动密切相关,而与夜间收缩压和舒张压波动无关.
목적 탐토혈압파동대노년남성뇌경사발생적영향.방법 1527례환유동맥경화적노년(년령＞65세)남성환자,소유환자감측동태혈압,근거유무뇌경사장입선환자분위2조:뇌경사조(607례)화비뇌경사조(920례),용수학평활곡선방법선장매일개체24 h혈압수거진행분석,재묘회출일조괄합개체혈압변화추세적곡선,계산실제혈압치여해추세곡선상응위치소형성차치적표준차즉위혈압파동치,연후비교2조혈압파동적정황.결과 뇌경사조중24 h적수축압파동치명현고우비뇌경사조[(8.4±2.2)여(8.0±2.0)mm Hg,t=-2.909,P＜0.01];기중자주수축압혈압파동명현승고[(8.2±2.2)여(7.8±2.1)mm Hg,t=-2.969,P＜0.01];이야간수축압파동2조차이무통계학의의[(8.9±3.9)여(8.7±3.7)mm Hg,P＞0.05];각계단서장기혈압파동차이무통계학의의[24 h서장압파동치(5.5±3.8)여(5.5±1.5)mm Hg,P＞0.05;백주서장압파동치(5.4±1.5)여(5.3±1.4)mm Hg,P＞0.05;야간서장압파동치(6.1±2.7)여(6.1±2.6)mm Hg,P＞0.05].결론 재노년남성동맥경화상관질병환자중,뇌경사적발생여백주수축압적파동밀절상관,이여야간수축압화서장압파동무관.
Objective , To investigate the influence of blood pressure variability on cerebral infarction in older men. Methods Ambulatory blood pressure was measured in 1527 elderly men ( older than 65 yrs) with atherosclerosis. All cases were divided into 2 groups: Six hundred and seven patients with cerebral infarction ( group A)and 920 patients without cerebral infarction ( group B). Smooth curve method was used to analyze each patient's ambulatory blood pressure data and the trend of each patient's blood pressure curve was portrayed. The differences between the actual blood pressure and the blood pressure on the curve was defined as blood pressure variability,and the blood pressure variability between the 2 groups was compared. Results The systolic blood pressure variability in 24 hours in group A was significantly higher than that in group B( [8.4'±2. 2]mm Hg vs [ 8.0 ± 2. 0 ] mm Hg, P ＜ 0. 01 ), especially for the systolic blood pressure variability in daytime( [ 8. 2 ± 2. 2 ] mm Hg vs [ 7. 8 ± 2. 1 ] mm Hg, P ＜ 0. 01 ). However, the systolic blood pressure variability at night was not significantly different between the 2 groups( [ 8.9 ± 3. 9 ] mm Hg vs [ 8. 7 ± 3.7 ] mm Hg,P ＞ 0. 05 ). There were no significant difference between the diastolic blood pressure of 24 hours( [5. 5 ± 3.8 ] mm Hg vs [5.5 ± 1.5 ]mm Hg,P ＞0. 05),during daytime([5.4 ± 1.5]mm Hg vs [5.3 ± 1.4] mm Hg,P ＞0.05)and nighttime ( [ 6. 1 ± 2.7 ] mm Hg vs [ 6. 1 ± 2. 6 ] mm Hg, P ＞ 0. 05 ). Conclusion In elderly men with atherosclerosis,cerebral infarction was closely related to systolic blood pressure variability,but independent of nighttime systolic blood pressure and diastolic blood pressure variability.