Department of Neurology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China.
Heilongjiang Key Laboratory of Ischemic Stroke Prevention and Treatment, Mudanjiang, China.
Comput Math Methods Med. 2022 Aug 8;2022:6364769. doi: 10.1155/2022/6364769. eCollection 2022.
The goals of this study are to assess the correlation between 24-hour ambulatory blood pressure (BP) variability and white matter lesions (WML) in patients with cerebral small vascular disease (CSVD) and to provide guidance for the prevention of WML.
A total of 136 patients diagnosed with CSVD and essential hypertension were recruited and divided into two groups. The Fazekas scale was used to quantify the severity of WML. The basic information, BP levels, BP variability, and circadian rhythm changes across these groups were recorded and compared.
The control group consisted of 40 subjects without WML (Fazekas score = 0), and the WML group was composed of 96 patients with WML (Fazekas score ≥ 1). Patients in the WML group were then divided into three subgroups: mild WML ( = 43, Fazekas score = 1), moderate WML ( = 24, Fazekas score = 2), and severe WML ( = 29, Fazekas score = 3-4). Age, history of diabetes, and serum uric acid levels were significantly increased between the WML and control groups ( < 0.05). The levels of 24-hour mean diastolic BP ( = 3.158, = 0.026) and daytime mean systolic BP ( = 3.526, = 0.017) were significantly increased between the control and WML groups. There was no significant difference in the rhythmic classification of BP among all groups ( > 0.05). An ordered multinomial logistic regression analysis revealed that age, triglyceride levels, and nondipper BP were independent risk factors in WML.
Age, history of diabetes, serum uric acid levels, 24-hour mean systolic level, and daily mean systolic BP level were significantly increased between the WML and control groups. Age, triglyceride levels, and nondipper BP were independent risk factors in WML in patients with CSVD, while the 24-hour dynamic blood pressure standard deviation and 24-hour dynamic blood pressure coefficient of variation were not associated with the occurrence of WML.
本研究旨在评估脑小血管病（CSVD）患者 24 小时动态血压（BP）变异性与脑白质病变（WML）之间的相关性，并为 WML 的预防提供指导。
共纳入 136 例 CSVD 合并原发性高血压患者，分为两组。采用 Fazekas 量表量化 WML 严重程度，记录并比较两组基本信息、BP 水平、BP 变异性及昼夜节律变化。
对照组无 WML（Fazekas 评分=0）40 例，WML 组 96 例（Fazekas 评分≥1），WML 组中 WML 患者再分为轻度（=43，Fazekas 评分=1）、中度（=24，Fazekas 评分=2）、重度（=29，Fazekas 评分=3-4）3 个亚组。WML 组与对照组相比，年龄、糖尿病史及血尿酸水平明显升高（均<0.05），24 小时平均舒张压（=3.158，=0.026）及日间平均收缩压（=3.526，=0.017）明显升高（均<0.05），BP 节律分组在各组间差异无统计学意义（>0.05）。有序多分类 Logistic 回归分析显示，年龄、甘油三酯水平及非杓型血压是 WML 的独立危险因素。
WML 组与对照组相比，年龄、糖尿病史、血尿酸水平、24 小时平均收缩压及日间平均收缩压明显升高，年龄、甘油三酯水平及非杓型血压是 CSVD 患者 WML 的独立危险因素，24 小时动态血压标准差、24 小时动态血压变异系数与 WML 的发生无关。
