CAJ | 학술논문

目的：探讨血压变异性（BPV）与高血压小卒中患者急性期神经功能恶化的关系。方法选取高血压小卒中患者200例，根据患者是否发生急性期神经功能恶化分为稳定组（182例）和恶化组（18例），比较2组患者24 h动态血压监测的BPV，24 h收缩压血压变异系数（24 h CVSBP）、24 h舒张压血压变异系数（24 h CVDBP）、白昼收缩压血压变异系数（dCVSBP）、白昼舒张压血压变异系数（dCVDBP）、夜间收缩压血压变异系数（nCVSBP）、夜间舒张压血压变异系数（nCVDBP）。采用Binary Logistic回归分析高血压小卒中患者急性期神经功能恶化的BPV相关因素。结果与稳定组比较，恶化组24 h CVSBP为17.75%（17.54%，19.26%）vs 12.78%（10.67%，14.39%）、24 h CVDBP为25.48%（20.77%，27.87%）vs 17.95%（14.88%，21.46%）、dCVSBP为18.61%（17.65%，20.65%）vs 12.30%（10.10%，14.75%）、dCVDBP为25.65%（21.25%，29.78%）vs 17.76%（14.89%，22.19%）均升高，差异有统计学意义（均P＜0.01）。Binary Logistic回归分析显示24 h CVSBP、dCVSBP是高血压小卒中患者急性期神经功能恶化的危险因素。结论24 h BPV和白昼BPV增加可能与高血压小卒中患者急性期神经功能恶化有关，在卒中急性期和二级预防中应关注BPV。
목적：탐토혈압변이성（BPV）여고혈압소졸중환자급성기신경공능악화적관계。방법선취고혈압소졸중환자200례，근거환자시부발생급성기신경공능악화분위은정조（182례）화악화조（18례），비교2조환자24 h동태혈압감측적BPV，24 h수축압혈압변이계수（24 h CVSBP）、24 h서장압혈압변이계수（24 h CVDBP）、백주수축압혈압변이계수（dCVSBP）、백주서장압혈압변이계수（dCVDBP）、야간수축압혈압변이계수（nCVSBP）、야간서장압혈압변이계수（nCVDBP）。채용Binary Logistic회귀분석고혈압소졸중환자급성기신경공능악화적BPV상관인소。결과여은정조비교，악화조24 h CVSBP위17.75%（17.54%，19.26%）vs 12.78%（10.67%，14.39%）、24 h CVDBP위25.48%（20.77%，27.87%）vs 17.95%（14.88%，21.46%）、dCVSBP위18.61%（17.65%，20.65%）vs 12.30%（10.10%，14.75%）、dCVDBP위25.65%（21.25%，29.78%）vs 17.76%（14.89%，22.19%）균승고，차이유통계학의의（균P＜0.01）。Binary Logistic회귀분석현시24 h CVSBP、dCVSBP시고혈압소졸중환자급성기신경공능악화적위험인소。결론24 h BPV화백주BPV증가가능여고혈압소졸중환자급성기신경공능악화유관，재졸중급성기화이급예방중응관주BPV。
Objective To investigate the relationship between blood pressure variability (BPV) and neurological deteri?oration (ND) during the acute phase in patients with hypertensive minor ischemic stroke. Methods A total of 200 hyperten?sive patients with acute minor ischemic stroke were recruited in this study. Patients were divided into two groups: stable group (n=182) and deterioration group (n=18) according to the neurological prognosis. Values of BPV in 24 h ambulatory blood pressure, 24 h systolic blood pressure variation coefficient (24 h CVSBP), 24 h diastolic blood pressure variation coeffi?cient (24 h CVDBP), day time systolic blood pressure variation coefficient (dCVSBP), day time diastolic blood pressure variation coefficient (dCVDBP), night time systolic blood pressure variability (nCVSBP) and night time diastolic blood pressure variability (nCVDBP) were compared between two groups. The related factors of BPV were analyzed by binary logistic method in the acute phase of patients with hypertensive minor ischemic stroke. Results There were significantly higher levels of 24 h CVSBP [17.75%(17.54%,19.26%) vs 12.78% (10.67%,14.39%)], 24 h CVDBP [25.48%(20.77%,27.87%) vs 17.95% (14.88%, 21.46%)], dCVSBP [18.61%(17.65%,20.65%) vs 12.30%(10.10%,14.75%)], dCVDBP [25.65%(21.25%,29.78%) vs 17.76%(14.89%,22.19%)] in deterioration group than those of stable group (P<0.01). Results of binary logistic regression analysis showed that values of 24 h CVSBP and dCVSBP were risk factors for neurological deterioration in the acute phase of patients with hypertensive minor ischemic stroke. Conclusion The increased 24 h BPV and day time BPV are correlated with neurologi?cal deterioration during the acute phase in hypertensive minor ischemic stroke patients. BPV should be concerned in the acute phase and secondary prevention in patients with ischemic stroke.