Gensini积分评价老年高血压患者冠状动脉病变与血浆致动脉粥样硬化指数的关系  

Correlation between atherogenic index of plasma and coronary artery lesions in hypertensive geriatrics by Gensini score

作　　者：肖健勇[1] 侯凯[1] 丛洪良[1] 

机构地区：[1]天津市胸科医院心内科,天津市心血管病研究所,天津300051

出　　处：《中华高血压杂志》2014年第6期545-548,共4页Chinese Journal of Hypertension

基　　金：天津市科学技术委员会天津市科技计划项目(12ZCZDSY03200)

摘　　要：目的通过Gensini积分评价老年高血压患者冠状动脉病变与血浆致动脉粥样硬化指数(AIP)的关系。方法2009年5月至2010年5月,入选天津市胸科医院以冠状动脉造影检查确诊冠状动脉性心脏病的高血压患者828例,年龄≥60岁且病历资料完整。将Gensini积分≥30分者归入高Gensini积分(H-Gensini)组(n=384),<30分者归入低Gensini积分(L-Gensini)组(n=444)。比较两组年龄、性别、吸烟史、既往心肌梗死病史、体质量指数(BMI)、收缩压、舒张压、纤维蛋白原(FIB)、空腹血糖、AIP、总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿素氮、血肌酐、血尿酸、血钾、左心房前后径(LAAPD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)和肺动脉收缩压(PASP)等指标差异。采用非条件Logistic回归分析,明确上述指标对老年高血压患者冠状动脉病变程度的影响。结果与L-Gensini组比较,H-Gensini组年龄[(70.3±6.9)比(69.2±7.0)岁]、BMI[(25.7±1.6)比(25.3±3.2)kg/m2]、空腹血糖[(6.8±2.1)比(5.6±1.2)mmol/L]、AIP[(0.11±0.19)比(0.08±0.17)]、LVEDD[(51.5±5.2)比(50.7±6.8)mm]和PASP[(38.9±6.0)比(31.9±3.7)mm Hg]较高;而舒张压[(84.5±13.8)比(89.7±18.8)mm Hg]和血钾[(4.12±0.44)比(4.15±0.40)mmol/L]较低(均P<0.05)。非条件Logistic回归分析显示,年龄、吸烟史、舒张压、AIP、空腹血糖和PASP是老年高血压患者冠状动脉病变程度的影响因素(均P<0.05),其中AIP(β=1.621,OR=5.057)与该人群冠状动脉病变程度的相关性最强。结论 AIP与老年高血压患者冠状动脉病变程度相关。Objective To evaluate the correlation between atherogenic index of plasma（AIP） and coronary artery lesions in hypertensive geriatrics by Gensini score. Methods A total of 828 hypertensive patients aged above 60 years old, who were admitted to Tianjin Chest Hospital from May 2009 to May 2010 and diagnosed coronary heart disease by coronary angiography, were enrolled in this study. The patients whose Gensini score was no less than 30 were in high Gensini（H-Gensini） group（n= 384）, and those with Gensini score less than 30 were in low Gensini （L-Gensini） group （n=444）. The other factors of two groups, such as age, gender, smoking history, myocardial infarction history, body mass index （BMI）, systolic blood pressure, diastolic blood pressure, fibrinogen （ FIB）, fasting blood glucose {FBG）, AIP, total cholesterol {TC）, triglyceride （TG）, high density lipoprotein cholesterol {HDL-C）, low density lipoprotein cholesterol （LDL-C）, serum urea, creatinine, uric acid, serum potassium, left atrial anterior-posterior diameter （LAAPD）, left ventricular end-diastolic diameter （LVEDD）, left ventricular ejection fraction （LVEF） and pulmonary arterial systolic pressure （PASP）, were compared. Multivariate Logistic regression analysis was performed to evaluate the assosiation between the above indexes and coronary artery lesions. Results Compared with those in L-Gensini group, the age[-（70.3±6.9） vs （69.2±7.0）years], BMI [-（25.7±1.6） vs （25.3±3.2） kg/m2 ], FBG [（6.8±2.1） vs （5.6± 1.2） mmol/L], AIP[（0.11±0.19） vs （0.08±0.17）], LVEDD [（51.5±5.2） vs （50.7±6.8）mini and PASP [-（38.9±6.0） vs {31.9±3.7）mm Hg] of H-Gensini group were higher, while diastolic blood pressrue[-（84.5±13.8） vs （89.7±18.8）mm Hg] and serum potassium ]-（4.12± 0.44） vs （4. 15±0.40） mmol/L-] were lower （all P〈0.05） in Hgensini group. Nonconditional Logistic regres sion analysis showed that age, smoking history, diastolic blood pre

关 键 词：老年 高血压 冠状动脉病变 血浆致动脉粥样硬化指数 GENSINI积分 

分 类 号：R544.1[医药卫生—心血管疾病]