原发性高血压患者血压变异性与冠状动脉病变程度的相关性分析

摘要

Objective To investigate the relationship between primary blood pressure variability and extent of coronary artery disease in patients with hypertension. Methods From January 2013 to November 2014, in the Fifth People's Hospital of Chengdu City 216 cases of patients with essential hypertension, according to the results of coronary angiog-raphy, were divided into the combined with coronary artery disease group (118 cases) and hypertension group (98 cas-es). According to Gensini score, patients in the combined with coronary artery disease group were divided into the mild, moderate and severe groups. The relationships among ambulatory blood pressure, total ischemia burden (TIB) and coro-nary artery Gensini score were analyzed. Results Combined with coronary artery disease group, 24 h SBP, dSBP, nSBP, 24 h SCV, 24 h DCV, dSCV, nSCV, dDCV, nDCV were significantly higher than those of hypertension group (P <0.05). In mild, moderate and severe groups, differences in 24 h SCV, 24 h DCV, dSCV, nSCV and TIB had statistically significant (P<0.05). 24 h SCV, dSCV were positively associated with TIB (P<0.05). 24 h SCV, dSCV, nSCV were positively correlated with Gensini score of coronary artery disease (P< 0.05). Results of multivariate linear regression analysis showed that 24 h SCV, dSCV, nSCV independently associated with coronary artery disease (P< 0.05). Con-clusion Blood pressure variability increases with the degree of coronary artery disease and elevates TIB. 24 h SCV, dSCV, nSCV independently associated with coronary artery disease.%目的：探讨原发性高血压患者血压变异性与冠状动脉病变程度的相关性。方法选择2013年1月~2014年11月于成都市第五人民医院诊治的216例原发性高血压患者,根据冠状动脉造影结果,分为合并冠脉病变组118例和单纯高血压组98例。合并冠脉病变组根据冠状动脉Gensini评分分为轻度组、中度组和重度组,分析动态血压、心肌缺血总负荷(TIB)及冠状动脉Gensini评分的关系。结果合并冠脉病变组24 h平均收缩压(24 h SBP)、日间平均收缩压(dSBP)、夜间平均收缩压(nSBP)、24 h收缩压变异系数(24 h SCV)、24 h舒张压变异系数(24 h DCV)、日间收缩压变异系数(dSCV)、夜间收缩压变异系数(nSCV)、日间舒张压变异系数(dDCV)、夜间舒张压变异系数(nDCV)均明显高于单纯高血压组(P<0.05)。轻度组、中度组和重度组24 h SCV、24 h DCV、dSCV、nSCV、TIB差异均有统计学意义(P<0.05)。24 h SCV、dSCV均与TIB呈正相关(P<0.05),24 h SCV、dSCV、nSCV均与冠状动脉病变Gensini评分呈正相关(P<0.05)。多元线性回归分析显示,24 h SCV、dSCV、nSCV与冠状动脉病变程度独立相关(P<0.05)。结论血压变异性随冠状动脉病变程度及TIB增加而升高；24 h SCV、dSCV、nSCV与冠状动脉病变程度独立相关。