【作者】 潘静；

【导师】 刘振国；

【作者基本信息】 上海交通大学 ， 神经病学， 2017， 硕士

【摘要】 背景和目的:脑白质疏松(LA)为一影像学名词,是指脑室周围或皮质下区(半卵圆中心)弥漫性非特异性白质损害。LA可增加脑卒中的风险及不良预后,并与认知功能下降、运动障碍、情绪改变等密切相关。本研究通过分析高血压病与非高血压病患者的脑白质疏松情况,以及脑白质疏松患者与非脑白质疏松患者血压水平,来探讨血压水平、血压变异性和脑白质疏松的关系,以期能够为早发现早预防该病提供参考。方法:收集214例患者为研究对象,根据头颅MRI结果进行LA评分,监测患者的血压水平,记录动态血压各参数。结果:高血压组与非高血压组之间LA评分有显著差异性(P<0.05)。进一步依据LA有无分组后,发现LA组年龄水平、高血压病人比例明显高于非LA组,肌酐、CYSC、空腹血糖、HCY、hsCRP值及CAS发生率也明显高于非LA组(P<0.05);LA组24h SBPmean、白天SBPmean、夜间SBPmax、夜间SBPmean明显高于非LA组(P<0.05),两组夜间SBP-SD、夜间DBP-SD比较差异也有统计学意义(P<0.05)。逻辑回归分析提示高血压是LA的明确危险因素,且二者之间关联程度很高。结论:高血压及昼夜血压变异性(尤其是收缩压水平及夜间血压变异性)与LA的发生发展密切相关,同时,年龄、肾功能、血糖水平、颈动脉硬化程度等也在LA的发生发展过程中起到一定的作用,为了能减少脑白质疏松的发生,延缓该疾病的进展,需要我们能更好地控制血压,尤其是对于高血压病患者。更多还原

【Abstract】 Objective:To investigate the relationship between blood pressure and its variability and leukoaraiosis.Methods:A total of 214 patients were analyzed retrospectively.The LA scores of all patients were graded according to MRI.The ambulatory blood pressure monitor was used to measure the blood pressure level parameters of the patients.Results:The LA scores between the hypertension group and the non-hypertension group have significant differences.Compared with the non-LA group,the LA group has a high level of age,Cr,CYSC,FBG,HCY,hsCRP,and a high incidence of hypertension and CAS.The datas of 24 h SBPmean、daytime SBPmean、nighttime SBPmax、nighttime SBPmean of the LA group are significantly higher than the non-LA group,and the datas of nighttime SBP-SD、nighttime DBP-SD are significantly different between the two groups.Binary logistic regression analysis indicates that hypertension is an independent risk factor of LA.Conclusions:The blood pressure level,blood pressure variability(especially the systolic blood pressure levels and nighttime BPV)are the important influencing factors of LA,of which hypertension is an independent risk factor.更多还原