24h平均脉压差与冠心病心律失常的相关性分析  

Relationship among 24h average pulse pressure coronary artery disease and arrhythmia in patients with essential hypertension and coronary heart disease

作　　者：谢洁[1] 时志城[2] 马兰[1] 

机构地区：[1]安徽医科大学第二附属医院,230601 [2]安徽医科大学第四附属医院,230022

出　　处：《临床心电学杂志》2014年第6期431-434,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨冠心病(CHD)合并高血压(HBP)患者24h平均脉压与冠状动脉病变程度及心律失常的关系。方法选择经冠脉造影、动态血压与心电同步监测等相关检查诊断为CHD合并HBP患者154例,依据24h平均脉压(PP)将其分为A、B两组,A组PP<50mm Hg、B组PP≥50mm Hg,对比两组冠状动脉病变程度、心律失常发生情况。结果 B组患者三支病变发生率及病变血管支数显著高于A组,p<0.01;B组患者双支病变发生率、冠脉狭窄积分、冠脉狭窄程度均高于A组,p<0.05;B组患者ST-T改变、心律失常的发生率均明显高于A组,p<0.05。结论采用24h动态血压和心电同步监测CHD合并HBP患者,发现脉压变大与冠状动脉病变程度、心律失常及心肌缺血呈正相关,表明PP是一项较为可靠且简便易行的客观评估CHD预后重要指标之一。Objective To evaluate the relationship among 24 h average pulse pressure（PP）,coronary artery disease and arrhythmia in patients with Hypertension（HBP） and Coronary Heart Disease（CHD）. Methods 154 Patients diagnosed as CHD and HBP proved by coronary angiography, synchronous monitor 24 h ambulatory blood pressure（A BP） and 24 h ambulatory electrocardiography（A ECG）. They were divided into group A（〈50mm Hg） and group B（≥50mm Hg） based 24 h PP. The coronary artery lesion severity and occurrence arrhythmia of two groups were compared. Results The incidence of 3 coronary artery disease in group B was higher than group A, p〈0.01; The incidence of 2 coronary artery disease, gensini integrals and coronary stenosis in group B were higher than group A,p〈0.05. The incidence of ST-T change and arrhythmia in group B were higher than group A, p〈0.05. Conclusions All patients with CHD and HBP were given 24 h A BP and 24 h A ECG,we find increased pulse pressure and coronary artery disease stenosis, arrhythmia and myocardial ischemia were positively correlated. The rusults show that PP is regarded as one of the more reliable and simple indexes for prognosis of CHD.

关 键 词：脉压 冠脉病变 心律失常 动态血压与心电同步监测 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]