脉压差在冠状动脉粥样硬化性心脏病诊断中的临床价值  

Clinical significance of pulse pressure in coronary heart disease diagnosis

作　　者：刘芳[1] 王立中[1] 弓梅芳[1] 李银花[1] 董鹏[1] 孙明利[1] 姜阳[1] 李远征[1] 任凤学[1] 

机构地区：[1]中国医科大学航空总医院心内二科,100012

出　　处：《中国医药》2015年第8期1116-1118,共3页China Medicine

摘　　要：目的 探讨脉压差在冠状动脉粥样硬化性心脏病（冠心病）诊断中的临床意义.方法 选择2010年1月至2014年12月中国医科大学航空总医院心内科高血压住院患者中拟诊为冠心病并行冠状动脉造影（CAG）的患者617例,按照CAG结果分为观察组（高血压合并冠心病患者322例）和对照组（单纯高血压患者295例）,比较2组收缩压、舒张压、脉压差等一般情况,将观察组根据不同脉压差、收缩压、舒张压进行分组,比较冠状动脉病变支数、长度和左心室射血分数（LVEF）.结果 2组舒张压、吸烟者比例比较,差异均无统计学意义（均P ＞0.05）;观察组患者年龄、男性比例、收缩压、脉压差均明显高于对照组[（61±9）岁比（55±5）岁,70.2％（226/322）比49.2％（145/295）,（144 ±5）mmHg（1 mmHg =0.133 kPa）比（130 ±5） mmHg,（71 ±9） mmHg比（51 ±6） mmHg],差异均有统计学意义（均P＜0.01）.将观察组患者根据脉压差、舒张压、收缩压高低进行分组后,脉压差≥60 mmHg组、舒张压＜60 mmHg组、收缩压≥140 mmHg组,冠状动脉双支及以上病变增多、病变长度增加、LVEF＜ 50％比例增加[脉压差≥60 mmHg组与＜ 60 mmHg组比较：73.1％（49/67）比62.0％（158/255）,（44 ±4）mm比（28 ±7）mm,6.0％（4/67）比1.5％ （4/255）;舒张压＜60 mmHg组与60 ～ 90 mmHg组比较：70.1％ （103/147）比57.2％ （83/145）,（48±7）mm比（23 ±3） mm,11.5％ （17/147）比4.1％ （6/145）;收缩压≥140 mmHg组与＜140 mmHg组比较：70.8％ （34/48）比61.7％ （169/274）,（41 ±4）mm比（17 ±7）mm,12.5％ （6/48）比6.6％ （18/274）],差异均有统计学意义（均P＜0.01）.结论 脉压差越大,冠状动脉病变越重,心功能不全比例升高,这可为冠心病及心功能不全的早期诊断提供一定帮助.Objective To investigate the clinical significance of pulse pressure in diagnosing coronary heart disease （CHD）.Methods Totally 617 patients with suspected coronary artery disease who underwent coronary angiography （CAG） from January 2010 to December 2014 were divided into observation group （hypertension complicated with CHD,322 cases）and control group（isolated hypertension,295 cases）according to CAG results.The systolic and diastolic blood pressure,pulse pressure and general data were compared between the two groups.The patients in observation group were divided into different subgroups according to the systolic and diastolic blood pressure,pulse pressure;the number and length 6f diseased coronary artery,ejection fraction （LVEF） were compared among different subgroups.Results The diastolic blood pressure and proportion of smoker had no statistical differences between control group and observation group （P 〉 0.05）;age,male ratio,systolic blood pressure and pulse pressure in observation group were significantly higher than those in control group [（61 ±9） years vs （55 ±5） years,70.2% （226/322） vs 49.2% （145/295）,（144 ±5） mmHg vs （130 ±5） mmHg,（71 ±9） mmHg vs （51 ±6） mmHg] （P 〈 0.01）.The numbers of diseased coronary artery,lesion length and proportion of LVEF 〈 50% were increased in pulse pressure ≥60 mmHg subgroup compared with those in pulse pressure 〈60 mmHg subgroup [73.1% （49/67） vs 62.0% （158/255）,（44 ±4） mm vs（28 ±7） mm,6.0% （4/67） vs 1.5% （4/255）];those data were also increased in systolic blood pressure 〈 60 mmHg subgroup compared with those in systolic blood pressure 60 ～ 90 mm-Hg and 〉90 mmHg subgroup [70.1% （103/147） vs 57.2% （83/145）,70.0% （21/30）,（48 ±7）mm vs （23 ± 3） mm,（42 ±7） mm,11.5% （17/147） vs 4.1% （6/145）,0.0% （0/30）];those data were also increased in diastolic blood pressure ≥ 140 mmHg subgroup compared with those in diastolic blood pressure 〈 14

关 键 词：冠状动脉粥样硬化性心脏病 脉压差 高血压 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]