H型高血压冠心病患者冠状动脉病变情况及性质  

Status of coronary artery lesion in patients with H-type hypertension complicated with coronary artery disease

作　　者：唐史林 黄康[1] TANG Shi-lin;HUANG Kang(Haikou People′s Hospital,Haikou 570000,China)

机构地区：[1]海口市人民医院,海口570000

出　　处：《岭南心血管病杂志》2019年第1期33-37,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨H型高血压冠状动脉粥样硬化性心脏病(冠心病)患者冠状动脉病变的情况及性质。方法收集2015年8月至2016年8月海口市人民医院心血管内科收治的原发性高血压(高血压)合并冠心病的患者200例作为研究对象。依据血浆同型半胱氨酸(homocysteine,Hcy)浓度分为H型高血压组和非H型高血压组,各100例。所有患者均行冠状动脉造影检查,比较两组Gensini积分、冠状动脉不同病变支数患者比例、稳定型心绞痛患者比例、不稳定型心绞痛患者比例及急性心肌梗死患者比例。比较H型高血压组单支病变亚组、双支病变亚组、多支病变亚组的Hcy浓度和Gensini积分;比较H型高血压组中稳定型心绞痛亚组、不稳定型心绞痛亚组及急性心肌梗死亚组的Hcy浓度和Gensini积分。分析冠状动脉病变程度与Hcy浓度的相关性。对冠心病的危险因素进行Logistic回归分析。结果 (1)H型高血压组的Gensini积分明显高于非H型高血压组,差异有统计学意义(P<0.05)。(2)H型高血压组双支病变和多支病变的患者比例明显高于非H型高血压组,差异有统计学意义(P<0.05)。(3)H型高血压组单支病变亚组、双支病变亚组、多支病变亚组的Hcy浓度和Gensini积分依次增高,差异有统计学意义(P<0.05)。(4)H型高血压组的不稳定型心绞痛和急性心肌梗死的患者比例明显高于非H型高血压组,差异有统计学意义(P<0.05)。(5)H型高血压组中稳定型心绞痛亚组、不稳定型心绞痛亚组及急性心肌梗死亚组的Hcy浓度和Gensini积分依次增高,差异有统计学意义(P<0.05)。(6)H型高血压组中Hcy浓度与Gensini积分呈正相关(r=0.224,P<0.05)。(7)Hcy、H型高血压分别是冠心病独立的危险因素。结论 H型高血压与冠心病密切相关,Hcy浓度与冠状动脉血管病变的严重程度具有正相关性;Hcy浓度、H型高血压可分别作为冠心病的独立危险因素。Objectives To investigate the status of coronary arteries in patients with H-type hypertension complicated with coronary artery disease.Method A total of 200 patients with hypertension complicated with coronary heart disease were enrolled in Haikou People′s Hospital from August 2015 to August 2016.According to plasma concentration of homocysteine(Hcy),the patients were divided into H-type hypertension group and non-H-type hypertension group with 100 cases in each group.All the patients underwent coronary angiography.Gensini scores,patient proportions of coronary artery count of,patient proportions of stable angina,unstable angina and acute myocardial infarction were compared between the two groups.Plasma concentration of Hcy and Gensini scores of single-vessel lesion subgroup,double vessel lesion subgroup,multi-vessel lesion,stable angina pectoris subgroup,unstable angina pectoris subgroup and acute myocardial infarction subgroup were compared in H-type hypertension group.Correlation between the degree of coronary artery disease and plasma concentration of Hcy was analyzed.Logistic regression analysis was performed on the risk factors of coronary heart disease.Results(1)Gensini score of hypertensive group was significantly higher than that of non-H group(P<0.05).(2)Patient proportions of double-vessel and multivessel lesions in hypertension group were significantly higher than those in non-H-type hypertension group(P<0.05).(3)Plasma concentrations of Hcy and Gensini scores of single-vessel lesion subgroup,double-vessel lesion subgroup and multi-vessel lesion subgroup in hypertension group gradually increased(P<0.05),which was statistically significant.(4)Patient proportion of unstable angina and acute myocardial infarction in H-type hypertension group was significantly higher than those in non-H group(P<0.05).(5)Plasma concentrations of Hcy and Gensini scores of stable angina pectoris subgroup,unstable angina pectoris subgroup and acute myocardial infarction subgroup gradually increased in H-type hypertension g

关 键 词：冠状动脉疾病 高血压 同型半胱氨酸 

分 类 号：R541.4[医药卫生—心血管疾病] R544.1[医药卫生—内科学]