脉压与冠状动脉病变严重程度的相关性研究  

RELATIONSHIP BETWEEN PULSE PRESSURE AND SEVERITY OF CORONARY ARTERY DISEASE

作　　者：贾永平[1] 王凤群[1] 吕吉元[1] 王睿[1] 高宇平[1] 刘春花[1] 郭志萍 

机构地区：[1]山西医科大学第一医院心内科,山西省太原市030001

出　　处：《中国煤炭工业医学杂志》2005年第11期1171-1173,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨脉压(pulse pressure,PP)与冠状动脉病变严重程度的关系.方法对156例入选病例均行冠状动脉造影术,其中男103例,女53例,年龄33～81岁,平均(59.15±10.60)岁.冠状动脉病变的严重程度用病变的血管支数及Gensini积分表示.所有病例均在术前、术后测量仰卧位肱动脉血压,术中测量主动脉血压,术后进行24h动态血压监测.结果高血压组较非高血压组冠心病患病率明显增高(76.9%;61.5%,P=0.038).高血压组患者冠脉三支血管病变的患病率显著高于非高血压组(35.2%;12.3%,P=0.001).冠脉狭窄组,无论肱动脉测压、主动脉测压还是24h动态测压,其SBP、PP均显著高于冠脉正常组,差异有统计学意义(P<0.05),且SBP与PP随着冠脉血管狭窄支数的增加而逐渐增加.多因素分析结果显示,动态PP[Exp(β)=0.389]、肱动脉PP[Exp(β)=0.357]、年龄与冠心病冠脉狭窄程度的关系最为密切.结论 PP是冠心病冠脉狭窄发生发展的独立危险因素,且24h动态PP的预测价值更大.Objective To evaluate the relationship between pulse pressure （PP） and the severity of coronary artery stenosis. Methods 156 patients were enrolled, 103 cases were men and 53 cases women, whose mean age was 33-81 （59.15 ± 10.60） years old.. All patients underwent coronary anglography, The severity of coronary artery lesions was evaluated by the number of disease arteries and Gensine score. Brachial systolic blood pressure （SBP） and diastolic blood pressure （DBP） were measured before and after coronary angiography. Aortic SBP and DBP were measured during the period of coronary anglography. All subjects underwent 24 - h arterial and blood pressure were monitored （ABPM）. Results Patients with essential hypertension had higher incidence of coronary heart disease （76.9% vs 61.5%, P = 0. 038） than those without essential hypertension. Patients with essential hypertension had higher incidence of 3 coronary artery disease（35.2% vs 12.3%, P = 0. 001） than those without essential hypertension. They were all significantly higher in patients with coronary artery disease than those in the normal subjects for Brachlal SBP and PP, Aortic SBP and PP, 24 - h arterial blood pressure monitoring （ABPM） SBP and PP. Multiple regression analysis indicated that ABPM PP[Exp（β） = 0. 389], Brachial PP [Exp（β） = 0. 357], and age were closely related to the severity of coronary lesions. Conclusion PP is an independent risk factor of the severity of coronary artery stenosis, and ABPM PP is a better predictor.

关 键 词：脉压 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]