Abstract: Objective To investigate the correlation between abnormal blood pressure regulation and cerebral microbleeds(CMBs) in patients with Parkinson's disease(PD).Methods Ninety-eight patients with PD admitted to our neurological department from January 2018 to September 2021 were selected,and patients' supine and orthostatic blood pressures were measured.24-hour ambulatory blood pressure monitoring(ABPM) was used to assess patients' orthostatic hypotension(OH),supine hypertension(SH),nocturnal hypertension(NH),and loss of nocturnal blood pressure dips(ND).Results CMBs were found in 14 patients(14.3%),six of these patients had deep or infratentorial CMBs,six had strictly lobar CMBs,and one had mixed CMBs.Linear regression analysis showed that after adjustment for age,sex,cardiovascular risk factors,and cerebral white matter hypertension,the coexistence of OH and SH was independently associated with an increased number of deep or infratentorial CMBs in PD patients,whereas NH and ND were not associated with CMBs in deep or infratentorial regions.Furthermore,any blood pressure variability did not correlate with the number of lobar CMBs.Conclusion Our results suggest that the presence of both OH and SH may be related to deep or infratentorial CMBs in patients with PD.

Key words: Cerebral microbleeds, Orthostatic hypotension, Supine hypertension, Parkinson's disease

摘要： 目的 探讨帕金森病(Parkinson's disease,PD)患者血压调节异常与脑微出血(cerebral microbleeds,CMBs)的相关性。方法 选取2018年1月至2021年9月本院神经内科收治的98例PD患者,检测患者卧位和立位血压,并使用24小时动态血压监测(ambulatory blood pressure monitoring,ABPM)来评估患者体位性低血压(orthostatic hypotension,OH)、卧位高血压(supine hypertension,SH)、夜间高血压(nocturnal hypertension,NH)及夜间血压不下降(non-dipping,ND)等情况。结果 14例(14.3%)患者存在CMBs,其中7例为深部-幕下CMBs,6例为脑叶CMBs,1例为混合性CMBs。线性回归分析表明,在校正了年龄、性别、心血管危险因素和脑白质高信号后,OH和SH的同时存在与PD患者脑深部-幕下CMBs数量增加独立相关,而NH和ND与脑深部-幕下区域的CMBs无关。此外,任何血压变异性与脑叶CMBs数量并不存在相关性。结论 我们的结果表明,OH和SH的同时存在可能与PD患者的脑深部-幕下CMBs相关。

关键词: 脑微出血, 体位性低血压, 卧位高血压, 帕金森病