RESUMEN
@#Objective To investigate the relationship between white matter hyperintensity and blood pressure variability and blood pressure rhythm in patients with acute lacunar stroke. Methods A total of 156 patients with acute lacuna stroke admitted to the Department of Neurology, Wuhan Hospital of Traditional Chinese and Western Medicine from January2017 to January 2019 were retrospectively enrolled, according to the results of cranial MRI examination, the enrolled patients were divided into mild white matter lesions group (n = 76) and moderate and severe white matter lesions group (n = 80) by Fazekas score. General information about vascular risk factors laboratory indicators and other findings were collected for both groups, the blood pressure variability and circadian rhythm were measured by 24 h ABPM, compare and analyze the related factors affecting WMI in patients with acute lacunar stroke. Results The history of prior stroke (P=0.005), the number of acute lacunar infarction (P=0.021), and the grade score of carotid plaque (P=0.041 ) in moderate and severe WMH group were higher than those in mild WMH group; The total day SBP-SD (P=0.01) daytime SBP-SD (P=0.004) daytime SBP-CV (P=0.018) daytime DBP-SD (P=0.028) were significantly increased in the moderate and severe WMH group; In the comparison of circadian rhythm of blood pressure between the two groups ,the riser pattern circadian rhythm in moderate and severe WMH group was significantly higher (P=0.03) ,and the arytenoid circadian rhythm in mild WMH group was higher (P=0.045). The multivariate Logistic regression analysis showed that the number of acute infarct lesions (OR=2.114, 95%CI 1.143-3.910, P=0.017) and riser pattern circadian rhythm (OR=0. 389, 95% CI 0.166-0.912, P=0.030) were independent risk factors for white matter hyperintensity in patients with acute lacunar stroke after adjusting for age, sex, and gender vascular risk factors (P<0.05). Conclusion WMH in patients with acute lacunar stroke is closely related to blood pressure variability (especially systolic blood pressure variability), and riser pattern circadian rhythm is an independent risk factor for WMH.