应激状态下血压升高患者冠状动脉狭窄与血管内皮功能的相关性

摘要

Objective:To investigate the correlation between vascular endothelial function and stenosis of coronary artery in non - hypertensive patients with elevated blood pressure under stress state. Methods: 1141 non -hypertensive patients with suspected coronary artery disease were selected. Coronary artery angiography was performed , and flow mediated dilatation ( FMD) was evaluated. The patients with blood pressure ≥ 140/90 mmHg during the coronary angiography were sorted out as the observation group while the patients with blood pressure < 140/90 mmHg during the coronary angiography as the control group. The correlation between vascular endothelial function and coronary artery stenosis was investigated . Results: The lumina diameters of coronary artery were normal or with a reduction of less than 50% in control group, but with a reduction of less than 50% or more than 50% in the observation group. The patients with a reduction of more than 50% were significantly more in observation group than those in control group (P <0. 05) while the patients with normal coronary artery were significantly more in control group than those in observation group (P <0. 05). FMD was significantly decreased in observation group than that in control group (P < 0. 05). Conclusion: Stenosis of coronary artery and vascular endothelial dysfunction had already existed in non — hypertensive patients with elevated blood pressure under stress. Stenosis of coronary artery is associated with vascular endothelial dysfunction.%目的:探讨在应激状态下血压升高的非高血压患者血管内皮功能与其冠状动脉狭窄的相关性.方法:选择1 141例疑诊冠心病的非高血压患者,所有患者均行冠脉造影检查及超声检测肱动脉介导的血管舒张功能,其中将冠脉造影过程中监测血压≥140/90 mmHg的患者分为观察组,而血压＜140/90 mmHg为对照组,观察术中血压升高的患者其冠状动脉狭窄与血管内皮功能的关系.结果:①对照组冠状动脉狭窄以正常和狭窄＜50％为主,而观察组则以狭窄＜50％和狭窄＞50％为主,观察组狭窄＞50％者例数显著高于对照组(P＜0.05),而对照组冠脉造影正常者例数显著高于观察组(P＜0.05).②观察组血管内皮依赖性舒张功能显著低于对照组.结论:在应激状态下血压升高的非高血压患者,业已存在血管内皮功能障碍及冠状动脉狭窄,其冠状动脉狭窄与内皮功能障碍有关.