脉压指数与冠状动脉狭窄程度的相关性研究  

Study of relationship between different pulse pressure indices and severity of coronary artery stenosis

作　　者：姬富才[1] 贾永平[1] 王风群 吕吉元[1] 高宇平[1] 王睿[1] 范春雨[1] 

机构地区：[1]山西医科大学第一附属医院心内科,太原市030001 [2]太原钢铁公司总医院

出　　处：《中国心血管病研究》2007年第8期564-567,共4页Chinese Journal of Cardiovascular Research

基　　金：山西省教育厅高校科技研究开发项目(No.20041011)

摘　　要：目的探讨脉压指数(PPI)与冠脉病变狭窄程度的关系。方法对156例入选病例均行冠脉造影术,其中男性103例,女性53例,年龄33～81(59.15±10.60)岁。所有病例均在术中测量主动脉血压,术后监测24h动态血压,并在术前、术后测量仰卧位肱动脉血压,记录其平均值。最后计算各PPI。冠脉病变的狭窄程度用病变的血管支数及Gensini积分表示。结果高血压(EH)组较非EH组冠心病(CHD)患病率明显增高(73.6%比58.5%,P=0.032);EH组患者冠脉3支血管病变的患病率显著高于非EH组(35.2%比12.3%,P=0.001);冠脉狭窄组,三种测压方式各收缩压(SBP)、脉压(PP)及PPI均显著高于冠脉正常组,差异有统计学意义(P<0.05),且各SBP、PP及PPI均随冠脉血管狭窄支数的增加而逐渐增加。多因素Iogistic回归分析结果显示,各PPI均与CHD冠脉狭窄程度的关系最为密切;且24h动态PPI较其他因素与CHD冠脉狭窄程度的关系更佳。结论各PPI均是CHD冠脉狭窄发生、发展的独立危险因素,且24h动态PPI的预测价值更佳。Objective To assess the relationship between different pulse pressure indices （PPI） and the severity of coronary artery stenosis. Methods One hundred and fifty-six patients were included. All patients （mean age 59.15±10.60 years, 103 males and 53 females） underwent coronary angiography. Brachial, aortic and 24 h ambulatory systolic blood pressure（SBP）,diastolic blood pressure（DBP） were measured before, midst and after coronary angiography. The severity of coronary artery stenosis was evaluated by the number of impaired arteries and Gensini score. Results Patients with essential hypertension （EH） had higher ineidenco of coronary heart disease＂ （CHD）（73.6% vs 58.5%,P=0.032）than those without EH. Patients with EH had higher ineidenco of 3 coro- nary artery lesions（35.2% vs 12.3%,P=0.001 ）than those without EH. They were aLl significantly higher in patients with CHD than in the normal subjects for either brachial, aortic or 24 h ambulatory SBP, PP and PPI. Logistic multivariate analysis indicated that PPI were aLl closely related to the severity of coronary artery lesions. And 24 h ambulatory PPI, compared with other factors, is the better predictor for the severity of coronary artery lesions. Conclusion PPI are aLl the independent risk factors of the severity of coronary artery stenosis, and the 24 h ambulatory PPI is the better predictor of severity of CHD.

关 键 词：脉压指数 冠状血管造影术 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]