高血压患者动态脉压指数与冠状动脉病变的相关性分析

摘要

Objective To investigate the correlation between ambulatory pulse pressure indexes (APPI) and coronary artery disease (CHD) in patients with hypertension. Methods The hypertensive patients (n=355) with coronary angiography (CAG) were chose from Apr. 2010 to Apr. 2013 and then divided into CHD group (n=237) and non-CHD group (n=118) according to CAG resutls. All patients were given 24-hour ambulatory blood pressure monitoring. The changes of SBP, DBP and pulse pressure (PP) were recorded and mean pressure [MBP=(SBP+DBP)/2] and PP index (PPI=PP/SBP) were calculated. The correlation between the above mentioned indexes and coronary artery lesions was analyzed. Results The levels of PP and APPI were higher in CHD group than those in non-CHD group [PP:(77.8±8.7) mmHg vs. (64.7±7.6) mmHg;APPI:(0.52±0.08) vs. (0.45±0.10) , P<0.05]. In CHD patients, the higher APPI value, the more severe coronary artery lesions (P<0.01). The results of Logistic analysis showed that APPI (OR=1.39), PP (OR=1.23) and SBP (OR=1.27) were risk factors of CHD (all P<0.01). Conclusion APPI value can be used for predict the severity of coronary artery lesions in patients with hypertension.%目的探讨高血压患者动态脉压指数（pluse pressure index，PPI）与冠状动脉病变的相关性。方法纳入2010年4月～2013年4月实施冠状动脉造影（CAG）的高血压患者355例。根据CAG结果将患者分为冠心病组（n=237）及非冠心病组（n=118）。对所有研究对象均进行24 h动态血压监测，记录收缩压（SBP）、舒张压（DBP）和脉压（PP），计算脉压指数（PPI，PPI=PP/SBP）。分析上述因素与冠状动脉病变的相关性。结果与非冠心病组相比，冠心病组患者PP及PPI水平更高，分别为（77.8±8.7）mmHg vs.（64.7±7.6）mmHg，（0.52±0.08） vs.（0.45±0.10），差异有统计学意义（P＜0.05）。在冠心病患者中，PPI值越高，患者冠脉病变数值越高（P＜0.01）。Logistic分析结果显示， PPI（OR=1.39）、PP（OR=1.23）、SBP（OR=1.27）均为冠状动脉病变发生的危险因素（P均＜0.01）。结论 PPI值有助于预测高血压患者冠状动脉病变的严重程度。