高血压晨峰现象与冠状动脉微循环的相关性  

Correlation Analysis between Morning Blood Pressure Surge and Coronary Microvascular dysfunction

作　　者：张健瑜[1] 梁茜[1] 许兆延[1] 李健[1] 岑锦明[1] 梅百强[1] 杨希立[1] 

机构地区：[1]广东省佛山市第一人民医院心内科,528000

出　　处：《实用医学杂志》2017年第24期4090-4093,共4页The Journal of Practical Medicine

基　　金：基金项目:广东省佛山市医学类科技攻关(编号:2015AB00315)

摘　　要：目的明确血压晨峰现象与冠脉微循环的关系,探讨影响冠脉微循环的因素。方法对入选患者进行24 h动态血压监测、冠脉微循环阻力指数检测,对所有患者进行血糖、总胆固醇(TCH)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、尿酸(SUA)检测,将高血压患者划分为晨峰组与非晨峰组。结果晨峰组与非晨峰组的一般统计学数据并无显著差异,生化指标差异亦无显著性,晨峰组的平均收缩压(24 h、白昼、夜间)、晨峰血压升高值与非晨峰组差异有统计学意义,但平均舒张压(24 h、白昼、夜间)与非晨峰组差异无显著性,年龄、24 h平均收缩压、白昼平均收缩压、夜间平均收缩压、晨峰血压升高值指标为IMR的相关因素,但只有晨峰血压升高值为冠脉微循环阻力指数的独立影响因素。结论晨峰现象对高血压有一定的影响,且晨峰血压升高值是冠脉微循环阻力指数的独立影响因素。Objective To investigate the correlation between morning blood pressure surge and Coronary Microvascular Dysfunction.Methods 58 cases of patients with hypertension in our hospital were given 24 h ambu-latory blood pressure monitoring（ambulatory blood pressure monitoring,ABPM）.The coronary microvascular dys-function was estimated by the index of microcirculatory resistance（IMR）. All cases were given biochemical test-ing,included TCH,TG,HDL-c,LDL-c and SUA.Results According to whether ABMP was arise,the patient were divided into MBPS group（n=21）and the Non-MBPS group（n=37）.24 h,day,night and morning peak of systolic blood pressure were significantly higher in the morning peak group than in the average morning peak group. Multiple linear regression analysis showed that,MBPS,24 h average systolic blood pressure,day average systolic blood pressure,night average systolic blood pressure,and age were independent risk factors for coronary artery disease.Conclusion Morning blood pressure surge is closely related to severity of coronary microcirculation dysfunction. It is an independent risk factor for coronary microcirculation dysfunction. To control the blood pres-sure in patients with hypertension effectively can reduce morning peak target organ damage.

关 键 词：晨峰 高血压 动脉微循环阻力指数 相关分析 

分 类 号：R544.1[医药卫生—心血管疾病]