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目的研究老年原发性高血压(EH)患者动态血压监测参数曲线下面积(AUC)与腔隙性脑梗死(CLI)的关系,为CLI的诊断提供依据。方法选取2014年6月至2016年1月在郑州市第十人民医院神经内科就诊的未经治疗的老年EH患者作为研究对象,其中,合并CLI患者42例,男性28例,女性14例,年龄(72.7±11.3)岁;1级高血压18例,2级高血压21例,3级高血压3例。单纯高血压患者45例,男性29例,女性16例,年龄(73.4±10.9)岁;1级高血压16例,2级高血压24例,3级高血压5例。动态血压监测CLI组及单纯EH患者的血压,计算AUC,比较两组患者之间的差异。用SPSS 17.0软件进行t检验。结果合并CLI患者24 h收缩压AUC(24 h SBP-AUC)、24 h脉压AUC(24 h PP-AUC)、夜间收缩压AUC(nSBP-AUC)及夜间脉压AUC(nPP-AUC)均明显高于单纯高血压组患者,差异均有统计学意义(P<0.01)。结论老年EH患者动态血压AUC增高可以导致CLI。
Objective To study the relationship between the area under the curve of ambulatory blood pressure monitoring parameters (AUC) and lacunar infarction (CLI) in senile patients with essential hypertension (EH) and provide evidence for the diagnosis of CLI. Methods Totally 42 untreated elderly patients with EH in the Department of Neurology, Tenth People’s Hospital of Zhengzhou City from June 2014 to January 2016 were enrolled. Among them, 42 patients with CLI, 28 males and 14 females, (72.7 ± 11.3) years old. There were 18 cases of grade 1 hypertension, 21 cases of grade 2 hypertension and 3 cases of grade 3 hypertension. 45 cases of simple hypertension, 29 males and 16 females, aged (73.4 ± 10.9) years; 16 cases of grade 1 hypertension, 24 cases of grade 2 hypertension, 5 cases of grade 3 hypertension. Ambulatory blood pressure monitoring of CLI and EH patients with blood pressure, AUC was calculated, and the differences between the two groups were compared. T test was performed using SPSS 17.0 software. Results 24 h SBP-AUC, 24 h PP-AUC, nSBP-AUC and nPP-AUC at 24 h were all significantly higher in patients with CLI Significantly higher than those in patients with hypertension alone, the differences were statistically significant (P <0.01). Conclusion The increase of ambulatory blood pressure AUC in elderly patients with EH can lead to CLI.