脉压/平均动脉压比率与冠状动脉病变程度的相关性研究

摘要

目的 探讨脉压/平均动脉压比率(PP/MAP)与冠状动脉病变程度的相关性,并探讨其在冠心病(CAD)诊断与治疗中的临床意义.方法 选自2014年10月至2015年12月于我院心内科住院行冠状动脉造影术的病人90例,根据造影结果分为CAD组(56例)及对照组(34例).术前分别测定病人的身高、体质量、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、肌酐(Scr)、尿酸(UA)等指标,术中测量主动脉血压值,计算身体质量指数(BMI)、脉压(PP)、平均动脉压(MAP),通过Gensini评分系统对病人冠状动脉病变严重程度进行评分.结果 2组病人的BMI、LDL-C、PP、PP/MAP差异具有统计学意义,CAD组明显高于对照组(P<0.01).PP/MAP与冠状动脉造影Gensini评分呈正相关(r=0.371,P<0.01),校正LDL-C、BMI后,两者仍呈明显的正相关(r=0.361,P<0.01).Logistic回归分析显示,BMI、LDL-C、PP/MAP是CAD的独立相关因素.结论 PP/MAP与CAD明显相关,PP/MAP可能是评价冠状动脉病变程度的指标之一.%Objective To evaluated the clinical significance of PP/MAP ratio in coronary artery disease ( CAD) , and to investigate the correlation between PP/MAP ratio and coronary stenosis degree. Methods A total of 90 patients undergoing selective coronary angiography, they were enrolled in this prospective study from October 2014 to December 2015 in our Hospital. According to the results of the angiography, they were divided into two groups, the CAD group ( n=56) and the control group ( n=44) . The body height, weight, total cholesterol ( TC) , triglyceride ( TG) , high-density lipoprotein cholesterol ( HDL-C) , low-density lipoprotein cholesterol ( LDL-C) , fasting blood glucose ( FBG) , serum creatinine ( Scr) , uric acid ( UA) were detected at the beginning of the study. Aortic blood pressure was measured during coronary angiography. The levels of body mass index (BMI), pulse pressure (PP) and mean aortic pressure ( MAP ) were calculated, and the severity of coronary atherosclerosis was evaluated using the Gensini score. Results BMI, LDL-C, PP and PP/MAP ratio in the CAD group were significantly higher than those in the control group ( P<0. 01) . The Gensini score was positively associated with PP/ MPA ratio(r=0. 371,P<0. 01), even after adjusting for confounding factors such as LDL-C and BMI ( r= 0. 361, P<0. 01 ) . Logistic regression analysis showed that BMI, LDL-C and PP/MAP were prominent predictors of CAD. Conclusions The level of PP/MAP is significantly correlated with CAD, It may be one of the parameters to evaluate the severity of CAD.