| Purpose: 1.Clarify the characteristic of blood pressure circadian rhythm in Parkinson’s disease(PD)patients.2.To explore the correlation between different blood pressure rhythms and motor and non-motor symptoms of PD patients,and the related influencing factors of abnormal blood pressure rhythm in PD.Methods: A retrospective analysis of 100 patients with PD from December2018 to January 2021 at Subei People’s Hospital of continuous treatment,while our hospital health examination center to improve health by sex and age ambulatory blood pressure assessment and PD patients in this group that matches 82 cases served as a control group.The parameters of ambulatory blood pressure and its coefficient of variation were obtained in these two goups.We gathered the information of PD group,which consisted of age,sex,height,weight,age of onset,duration,personal history(smoking history,drinking history,pesticide exposure history),years of education and PD family history,and we collected the laboratory parameters.The total score of UPDRS and UPDRS Ⅲ score,mini mental state assessment scale(MMSE),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),autonomic neurosis scale(SCOPA-AUT),non-motor symptom screening scale(NMSQ)and Pittsburgh sleep quality index(PSQI)were recorded in patients with Parkinson’s disease.The average blood pressure of day,night and all day were cassetted.Calculating the coefficient of variation corresponding to the blood pressure index.Based on the △ n-SBP% we divided PD patients into dipper,non-dipper and reverse dipper group.The baseline data,ambulatory blood pressure parameters,motor and non-motor symptom scores and related Laboratory indicators were compared among the three groups.Correlation analysis and multiple linear regression analysis were used to determine the correlation between △n-SBP% and each variable.Results:1.PD group and control group were significantly different in △ n-SBP%,n-SBP,variation coefficient of 24 hours systolic and daytime systolic and diastolic pressure.In the control group,dipper,non-dipper,reverse dipper and extreme dipper accounted for 60.98%,31.71%,4.88% and 2.44%,respectively.In the PD group,dipper,non-dipper and reverse dipper accounted for 29%,35%,36% respectively,and no patients with extreme dipper blood pressure were detected.Abnormal circadian rhythm of blood pressure(non-dipper and reverse dipper)in PD group accounted for 71%.2.Patients with different blood pressure rhythm groups had statistically significant differences in course of disease,gender,and glycosylated hemoglobin(P<0.05).The comparison between groups showed that the duration in the reverse dipper group was longer than that in the dipper group and the non-dipper group(P=0.01,P=0.008).The glycosylated hemoglobin of the dipper group was obviously lower than that of the non-dipper group and the reverse dipper group(P=0.033,P=0.012).3.There were statistically significant differences in △n-SBP%,n-SBP,and n-DBP among different rhythm patterns(P<0.05).We found that n-SBP,n-DBP and △n-SBP% in the reverse dipper group were significantly higher than dipper and non-dipper group when we compared two groups.The n-SBP and △ n-SBP% of the non-dipper group were significantly higher than dipper group(P<0.05).4.There were statistically significant differences on MMSE,HAMD,SCOPA-AUT,HAMA,NMSQ,Mo CA,SCOPA-AUT score among different rhythm patterns(P <0.05).The score of NMSQ,HAMD and HAMA in the reverse dipper group were significantly higher than dipper group(P=0.002,P=0.002,P=0.004),while the MMSE and Mo CA score lower than dipper group.The HAMD and SCOPA-AUT score in reverse dipper group were evidently higher than non-dipper group(P = 0.023,P = 0.012).5.△ n-SBP% was negatively correlated with duration,NMSQ score,HAMA score,HAMD score,PSQI score,SCOPA-AUT score and Hb A1 c score,but positively correlated with MMSE score and Mo CA score.Multiple linear regression analysis showed that △ n-SBP% was negatively correlated with duration and Hb A1 c.Conclusion:1.The dipper blood pressure rhythm was dominant in the normal population,but the circadian rhythm of blood pressure was abnormal in PD patients,and the proportion of dipper blood pressure decreased.We have seen increased blood pressure variability in PD patients.2.PD patients with abnormal blood pressure circadian rhythm had a longer duration,and their cognitive impairment,anxiety and depression scores and autonomic nervous symptom scores were higher than those of PD patients with normal blood pressure rhythm.3.The decreasing rate of nocturnal systolic blood pressure in patients with PD was correlated with duration,non-motor symptom score,anxiety and depression score,sleep quality,autonomic nervous symptom score,cognitive function and glycosylated hemoglobin.The decrease rate of nocturnal systolic blood pressure was negatively correlated with the duration and glycosylated hemoglobin.The duration and the level of glycosylated hemoglobin are independent risk factors for abnormal circadian rhythm of blood pressure. |
