【摘要】 目的 探讨老年缺血性脑血管病患者24 h脉压、脉压指数水平及ApoE基因型频率分布与脑微出血的关系。方法 纳入2022年7月至2023年7月蚌埠医科大学附属蚌埠市第三人民医院神经内科住院的缺血性脑血管病患者146例，根据磁敏感加权成像(SWI)检测结果分为非CMBs组和CMBs组。收集并记录入组患者临床资料及24 h脉压、脉压指数，并检测ApoE基因多态性。结果 非CMBs组与CMBs组24 h脉压、脉压指数水平、ApoE基因型及等位基因频率分布差异有统计学意义(P<0.05);Logistic回归分析结果显示，ε4等位基因携带组(OR=5.321,95%CI:1.849～15.318)、24 h脉压(OR=1.086,95%CI:1.031～1.143)是老年缺血性脑血管病发生脑微出血的危险因素；ε4等位基因携带组增加了脑叶、深部/幕下组微出血发生率，24 h宽脉压增加了深部/幕下组CMBs发生率。结论 24 h脉压、脉压指数水平以及ApoE基因型频率分布与老年缺血性脑血管病发生脑微出血具有一定的关系，ε4等位基因、24 h宽脉压增加脑微出血风险。更多还原

【Abstract】 Objective To investigate the relationship between 24-hour pulse pressure, pulse pressure index, ApoE genotype frequency distribution, and cerebral microhemorrhage in the elderly patients with ischemic cerebrovascular disease. Methods A total of 146 patients with ischemic cerebrovascular disease were admitted in the Department of Neurology at Bengbu Third People’s Hospital Affiliated with Bengbu Medical University from July 2022 to July 2023. The patients were divided into two groups based on the detection results of susceptibility weighted imaging(SWI): the non-CMBs group and the CMBs group. We collected and recorded the clinical data, the 24-hour pulse pressure, the pulse pressure index and ApoE gene polymorphism of all enrolled patients. Results The study found significant differences between the non-CMBs group and the CMBs group in terms of 24-hour pulse pressure, pulse pressure index, ApoE genotype, and allele frequency distribution(P<0.05). The logistic regression analysis showed that ε4 allele carrying(OR=5.321, 95%CI:1.849～15.318) and 24-hour pulse pressure(OR=1.086, 95%CI:1.031～1.143) were risk factors for cerebral microbhemorrhage in elderly patients with ischemic cerebrovascular disease. The ε4 allele carrying group had an increased incidence of microbleeding in the lobar and deep/subtentorial groups. Additionally, a wide 24-hour pulse pressure increased the incidence of CMBs in the deep/subtentorial groups. Conclusion In elderly patients with ischemic cerebrovascular disease, cerebral microhemorrhage is associated with 24-hour pulse pressure, pulse pressure index and ApoE genotype frequency distribution. The ε4 allele carrying and 24-hour wide pulse pressure increase the risk of cerebral microhemorrhage.更多还原