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目的探讨高血压性急性脑血管病的发病时间规律,寻求更适当及时的预防及治疗的方法。方法选取神经内科高血压性脑血管病患者200例作为观察组,收集临床资料,系统分析高血压性急性脑血管病的发病时间规律。选取同期轻中度高血压住院且未发生急性脑血管疾病的患者200例作为对照组,比较血压随着时间的变化规律。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果脑出血的好发时间为上午,脑梗死的好发时间为早晨和上午,腔隙性脑梗死的好发时间为上午。观察组患者各时间段内平均收缩压、舒张压均较对照组高,差异均有统计学意义(t=12.596、10.978、22.169、15.483、16.019、18.040,均P<0.05)。急性脑血管组患者夜间平均收缩压、舒张压下降较少,减小幅度明显低于对照组,差异均有统计学意义(t=38.503、26.765、21.308、43.568,均P<0.05)。结论高血压患者急性脑血管病的发生与昼夜节律密切相关,因此,临床上对血压实时监测,注意调节患者的昼夜血压波动,对于预防脑血管病的发生具有指导意义。
Objective To explore the pathogenesis of hypertensive acute cerebrovascular disease and to find a more appropriate and timely method of prevention and treatment. Methods 200 patients with neurogenic hypertensive cerebrovascular disease were selected as the observation group, clinical data were collected, the pathogenesis of hypertensive acute cerebrovascular disease was systematically analyzed. Two hundred and seventy patients with mild-to-moderate hypertension and hospitalized without acute cerebrovascular disease were selected as the control group, and the changes of blood pressure with time were compared. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The onset time of cerebral hemorrhage was morning, the onset time of cerebral infarction was morning and morning, lacunar infarction occurred in the morning. The average systolic pressure and diastolic pressure in observation group were higher than those in control group in each time period (t = 12.596,10.978,22.169,15.483,16.019,18.040, both P <0.05). The average nighttime systolic blood pressure and diastolic blood pressure in patients with acute cerebrovascular disease decreased less than those in the control group (t = 38.503,26.765,21.308,43.568, all P <0.05). Conclusions The incidence of acute cerebrovascular disease in patients with hypertension is closely related to the circadian rhythm. Therefore, it is instructive to monitor the blood pressure in real time and pay attention to the fluctuations of diurnal blood pressure in patients with hypertension in order to prevent the occurrence of cerebrovascular disease.