Correlation Between Acute Cerebral Infarction Complicated With Sleep Disorder And Blood Pressure Variability

Objective :To study the effects of sleep disorders on blood pressure levels,blood pressure circadian rhythms,and blood pressure variability in patients with acute cerebral infarction,to explore the correlation between sleep disorders and serum brain-derived neurotrophic factor(BDNF),and the related mechanisms of sleep disorders affecting blood pressure variability in stroke patients.Screening for risk factors affecting blood pressure variability in stroke patients.To provide a theoretical basis for effective regulation of blood pressure in acute stroke.Methods:Patients with acute cerebral infarction who were admitted to the first episode or previous stroke without sequelae in Dalian Central Hospital from July 2018 to January 2019,The National Institute of Health Stroke Scale(NIHSS)score ? 5 points,and no significant aphasia or mental retardation can independently complete the relevant scale assessment.On the second day of admission,the Pittsburgh sleep quality index(PSQI)was completed.according to PSQI results was divided into stroke-combined sleep disorder group(PSQI>7 points)and stroke without sleep disorder group(PSQI?7 points).Record relevant data such as general clinical data [such as age,history of hypertension,etc.],routine tests [such as total cholesterol(TC),homocysteine(HCY),etc.],blood pressure-related data [such as 24 h blood pressure Variability,nocturnal blood pressure variability,etc.],laboratory test results(BDNF),The data of the two groups were compared,Statistical software was used to analyze the correlation between BDNF and sleep disorders etc.Results:A total of 78 patients with ischemic stroke were enrolled,Excluding 15 patients with ambulatory blood pressure results that did not meet the requirements,mid-course oral antihypertensive or sleep drugs,and patients who did not meet the other requirements of the study,and finally enrolled in 63 patients.There were 34 patients(53.79%)in the sleep disorder group and 29 patients(46.03%)in the no sleep disorder group.After analysis,there was no significant difference between the two groups in general clinical data(such as age,history of hypertension,etc.)and routine laboratory indicators(such as TC,Hcy,etc.).Comparing the blood pressure-related indicators of the two groups,the average blood pressure level of the sleep disorder group was higher than that of the no sleep disorder group(24h systolic blood pressure(151.15±21.23 VS 139.14±12.33,P=0.009),24 h diastolic blood pressure(83.47±8.99 VS).76.59±8.50,P=0.003),daytime systolic pressure(153.06±18.37 VS 140.10±14.26,P=0.003),daytime diastolic pressure(84.15±7.83 VS 78.28±8.64,P=0.005),nighttime systolic pressure(147.82±17.73)VS 135.34±15.17,P=0.004),nighttime diastolic pressure(79.41±14.11 VS 71.66±9.90,P=0.016));Moreover,the blood pressure variability of the sleep disorder group was higher than that of the no sleep disorder group(24h systolic blood pressure standard deviation(14.46±2.99 VS 12.07±3.54,P=0.005),24 h diastolic blood pressure standard deviation(11.53±2.65 VS 9.83±2.34,P= 0.01),standard deviation of daytime systolic pressure(14.86±3.01 VS 12.56±2.83,P=0.003),standard deviation of daytime diastolic pressure(11.14±3.04 VS 9.82±2.56,P=0.07),standard deviation of nighttime systolic pressure(12.04±3.05)VS 10.26±2.76,P=0.019),standard deviation of nighttime diastolic pressure(12.38±3.23 VS 10.12±2.72,P=0.004));The proportion of non-dipping blood pressure in the sleep disorder group was significantly higher than that in the no sleep disorder group(27(79.41%)vs 14(48.28%),P = 0.01).BDNF levels were compared between the two groups,and the sleep disorder group was significantly lower than the no sleep disorder group(26.39±6.38 ng/ml VS 31.39±5.49 ng/ml,P=0.002).Pearson correlation analysis showed that serum BDNF levels were negatively correlated with sleep disturbance(PSQI total score)(r=?0.405,P<0.05).Conclusion:Patients with acute cerebral infarction complicated with sleep disorder have higher systolic and diastolic blood pressure levels,higher proportion of non-dipper blood pressure,higher 24-hour systolic blood pressure variability,higher 24-hour diastolic blood pressure variability,higher daytime systolic blood pressure variability,higher night systolic blood pressure variability and higher diastolic blood pressure variability.However,its serum BDNF level is lower.Serum BDNF levels were negatively correlated with acute cerebral infarction complicated with sleep disorder.