| Objectives To investigate the relationship between blood pressure variability(BPV)and carotid artery stenosis in patients with transient ischemic attack(TIA).Methods 1 300 patients with transient ischemic attack were hospitalized in Department of Neurology Affiliated Hospital of North China University of Science and Technology from January 2016 to December 2017.180 controls were people in the physical examination center of our hospital at the same time.All patients underwent 24 hours ambulatory blood pressure monitoring(ABPM).2 TIA patients were divided into TIA in the former circulation group and TIA in the posterior circulation group according to different vascular involvement.According to the results of the ABCD2 score,the patients were divided into low-risk group,intermediate-risk group,and high-risk group;and the frequency of episodes within 24 hours of TIA patients was divided into frequent attack group(frequency)and non-frequent group(non-frequent group);According to the progression of cerebral infarction in TIA patients within 30 days,the progress was divided into cerebral infarction group and non-progressive cerebral infarction group.The blood pressure variability between the above groups was compared and circadian rhythm of blood pressure and analysis of blood pressure variability in patients with TIA.3 According to carotid ultrasound findings,TIA patients were divided into carotid artery stenosis group(stenosis group)and carotid artery stenosis group(no stenosis group);according to the degree of carotid artery stenosis,carotid artery stenosis was divided into mild carotid artery stenosis group,moderate stenosis group and severe stenosis group to analyze the relationship between blood pressure variability and carotid artery stenosis and stenosis in patients with TIA.Results 1 The 24 h SSD,24 h DSD,d SSD,d DSD,n SSD,and n DSD values of TIA patients were all higher than those of healthy individuals(P<0.05).The proportion of TIA patients with delirium rhythm was significantly lower(36.0%)compared with the healthy group(48.9%),the proportion of non-diegetic rhythm patients(36.7%)was significantly higher than the healthy group(26.1%)(P<0.05).2(1)Compared with the blood pressure variability of patients with TIA before and after circulation,the 24 h SSD,24 h DSD,d SSD,and d DSD values in the posterior circulation TIA group were higher than those in the former circulation group(P<0.05).The TIA type rhythm in the posterior circulation group was significantly higher.The proportion of patients(29.5%)was significantly lower than that of the pre-circulation group(47.3%),and the proportion of non-diaphragmatic rhythm patients(42.1%)was increased(P<0.05);(2)The 24 h SSD,24 h DSD,d SSD,d DSD,and n SSD in the high-risk group with ABCD2 score were higher than those in the low-risk group and the middle-risk group,and the difference was statistically significant(all P<0.05).The circadian rhythm of blood pressure was different in patients with different ABCD2 scores.There were differences,with the lowest risk group(14.8%)being the most common type of rhythm patients(48.1%),the middle risk group(31.5%,38.2%),and the highest risk group(45.9%),patients with non-dipper rhythm were the least(30.6%),and the difference was statistically significant(P<0.05);(3)Among TIA patients,the 24 h SSD,24 h DSD,d SSD,d DSD,n SSD,and n DSD in patients with frequent TIA were higher than those in the non-frequent group.The difference was statistically significant(all P<0.05),and frequent TIA patients had spastic rhythm patients,the proportion of patients(27.5%)was significantly lower than that of the non-frequent TIA group(49.2%),and the proportion of non-deaf rhythm patients(40.7%)was higher than that of the non-frequent group(30.5%).The difference was statistically significant(P<0.05);(4)In TIA patients,the 24 h SSD and d SSD values of cerebral infarction patients with TIA were significantly higher than those of TIA patients without cerebral infarction(all P<0.05).The proportion of rhythm patients(22.4%)was significantly lower than that of TIA patients(42.6%)who did not progress to cerebral infarction,and the proportion of non-artificial rhythm patients(45.9%)was increased.3 The 24 h SSD,24 h DSD,d SSD,d DSD,and n SSD in the carotid artery stenosis group were significantly higher than those in the carotid artery stenosis group(P<0.05,P<0.01),and the proportion of patients with carotid artery stenosis was significantly lower than that of the carotid artery stenosis group(30.2%),no carotid artery stenosis group(50.0%),non-dipper type rhythm patients(40.6%)was significantly higher than the group without carotid artery stenosis(27.3%),the difference was statistically significant(P<0.05).The 24 h SSD,24 h DSD,d SSD and d DSD in the moderate carotid artery stenosis group and severe stenosis group were significantly higher than those in the mild stenosis group(P<0.05).Compared with the circadian rhythm of blood pressure in the three groups,the patients with severe carotid artery stenosis group had the least twitch rhythm(14.0%),but not the sigmoid rhythm patients(52.6%),the moderate stenosis group(28.6%,45.7%),mild patients with sacral rhythm in the narrow group were the most(47.1%)but not in the sacral rhythm(28.2%),and the difference was statistically significant(P<0.05).Conclusions 1 The blood pressure variability of patients with TIA was significantly increased,the proportion of patients with spastic rhythm was significantly reduced,and the proportion of patients with non-spastic rhythm increased significantly.2 The blood pressure variability of post-cycle TIA and those with high ABCD2 scores,frequent TIA patients,and TIA patients with progressive cerebral infarction is significant,and the blood pressure variability is related to TIA type and condition.3 The blood pressure variability of TIA patients is closely related to carotid artery stenosis.The greater the variability of blood pressure,the more severe the carotid stenosis. |
PDF Full Text Request