血压变异性与稳定型心绞痛患者冠状动脉病变程度的相关性研究  

The correlation research of blood pressure variability and coronary artery disease in the stable angina patients

作　　者：范军[1] 韩昊[1] 徐新娜[1] 赵兴山[1] 郝志华[2] 

机构地区：[1]北京积水潭医院心内科,北京市100035 [2]河北省人民医院体检中心

出　　处：《中国心血管病研究》2016年第4期330-333,共4页Chinese Journal of Cardiovascular Research

基　　金：河北省2014年度医学科学研究重点课题（项目编号：ZD20140228）

摘　　要：目的探讨血压变异性与稳定型心绞痛患者冠状动脉病变程度的相关性。方法2011年7月到2015年2月选择在北京积水潭医院进行诊治的稳定型心绞痛患者80例，其中单支病变组50例、双支病变组20例、三支病变组10例；同期在我院住院的疑诊冠心病，经冠脉造影证实非冠心病患者32例作为对照组。所有患者都进行了常规指标调查、血压变异性监测和冠状动脉病变程度判断，同时进行了相关性分析及危险因素分析。结果三支病变组、双支病变组、单支病变组和对照组Gensini积分分别为（67．43±12．24）分、（42．32±12．49）分、（21．24±12．78）分和（6．67±2．45）分，组间对比差异均有统计学意义（P〈0．05）。冠脉病变组的24h收缩压（24hSBP）、24h舒张压（24hDBP）和24h平均脉压（24hPP）值均明显高于对照组（P〈0．05），且随着狭窄支数的增多血压变异性逐渐增大（P〈O．05）。Spearman相关分析显示，稳定型心绞痛患者24hSBP、24hDBP和24hPP均与Gensini积分存在显著正相关（r=0．233，0．193，0．313，P〈0．05）。多因素Logistic逐步回归分析结果表明，24hSBP、24hDBP、24hPP对冠脉狭度程度有独立的预测价值（P〈0．05）。结论稳定型心绞痛患者多表现为血压变异性大，且与冠状动脉病变程度存在明显的相关性，血压变异性也可能是冠状动脉病变发生发展的独立预测指标。Objective To investigate the correlation of blood pressure variability and coronary artery dis- ease in the stable angina patients. Methods From July 2011 to February 2015 in Beijing Jishuitan Hospital, se- lected 80 stable angina patients that included the coronary artery disease group that 50 patients of single vessel dis- ease group, 20 patients of double vessel disease group, 10 patients of triple vessel disease group, 32 patients of healthy people. All patients were underwent routine indicator survey, blood pressure monitoring and severity of coronary artery disease variability judgment, and were given the correlation analysis and risk factors analysis. Results The Gensini scores in the triple vessel disease group, double vessel group, single vessel disease group and healthy control group were （ 67.43 ± 12.24 ）points, （42.32± 12.49 ）points, （ 21.24± 12.78 ）points and （ 6.67±2.45 ） points, compared among the groups differences were statistically significant （P〈0.05）. The 24 h SBP, 24 h DBP and 24 h PP values in the coronary artery disease group were significantly higher than those of healthy control group （P〈0.05）, and with the increased in the narrow count gradually increased（P〈0.05）. Spearman correlation analysis showed that the 24 h SBP, 24 h DBP and 24 h PP in patients with stable angina were significantly positively cor- related with Gensini scores （r=0.233,0.193,0.313, P〈0.05 ）. Multivariate Logistic regression analysis showed that 24 h SBP, 24 h DBP, 24 h PP were the independent predictive value for the coronary artery disease （P〈0.05）. Conclusion The blood pressure variability in the patients with stable angina symptoms are big, and with the pres- ence of significant coronary axtery disease relevance, the blood pressure variability may also be an independent pre- dictor of the development of coronary artery disease.

关 键 词：血压变异性 稳定型心绞痛 冠状动脉病变程度 相关性 

分 类 号：R541.4[医药卫生—心血管疾病]