Stroke:舒张压和局灶性脑白质高信号负荷有什么关系?

2020-03-30 shaosai MedSci原创

目前,很少有研究来探讨收缩压和舒张压(DBP)对亚临床脑血管病分别有什么影响,尤其是参照2017心血管美国学会/美国心脏学会血压指南进行评价。此外,其与特异性区域白质异常高信号(WMHV)尚

背景和目的

目前,很少有研究来探讨收缩压和舒张压(DBP)对亚临床脑血管病分别有什么影响,尤其是参照2017心血管美国学会/美国心脏学会血压指南进行评价。此外,其与特异性区域白质异常高信号(WMHV)尚不明确。

本研究数据来自NOMAS项目,一项有关脑卒中风险和老年性认知功能评价的前瞻性研究。本研究评价了收缩压、舒张压与局灶性WMHV的相关性。利用线性混合模型方法评估局部脑区指标相关的因素。

结果

本研究共纳入了1205例患者,其中女性占61%。在不同区域DBP水平与WMHV具有显著相关性。与DBP DBP 90+ mm Hg的患者相比,DBP <80 mm Hg的受试者在额叶、顶叶、侧脑室前角和侧脑室后角区域发生WMHV分别要低13 (95% CI, -21% to -3%)、11% (95% CI, -19% to -1%)、22% (95% CI, -30% to -14%)、16% (95% CI, -24% to -6%)。与DBP 90≥ mm Hg 的受试者相比,DBP 80-89 mm Hg之间的受试者在侧脑室前角、侧脑室后角区域出现WMHV的可能性分别要低12% (95% CI, -20% to -3%)、9% (95% CI, -18% to -0.4%)。配对T检验表面脑室旁WMHV的估值与颞叶WMHV的估值具有显著性差异(P<0.05)。收缩压与局灶性WMHV并无显著相关性。

结论

DBP越低,局灶性白质异常高信号越低,尤其是在脑室周围的白质异常高信号。

原始出处:

Caunca MR, Simonetto M, Cheung YK. et al Diastolic Blood Pressure Is Associated With Regional White Matter Lesion Load: The Northern Manhattan Study. DOI: 10.1161/STROKEAHA.119.025139

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    2020-03-31 njwbhuang

    不错的研究。

    0

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    2020-03-30 天地飞扬

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