高血压患者动态脉压和脉压指数与并发冠心病的关系  

Relationship between dynamic pulse pressure and pulse pressure index and coronary heart disease in patients with hypertension

作　　者：龚心文 蔡海军 雷英 GONG Xin-wen;CAI Hai-Jun;LEI Ying(Department of Cardiology,Ankang Traditional Chinese Medicine Hospital,Ankang 725000,China;Functional Department,Ankang Traditional Chinese Medicine Hospital,Ankang 725000,China)

机构地区：[1]安康市中医医院心内科,陕西省安康市725000 [2]安康市中医医院功能科,陕西省安康市725000

出　　处：《中国心血管病研究》2020年第5期413-417,共5页Chinese Journal of Cardiovascular Research

基　　金：陕西省卫生科研项目(2016D015)。

摘　　要：目的探讨高血压患者24 h动态脉压(24hPP)、24 h动态脉压指数(24hPPI)与并发冠心病的关系.方法选取2019年1~6月期间在安康市中医医院接受治疗的高血压患者150例,根据是否合并冠心病将其分为高血压组(96例),高血压合并冠心病组(54例).比较两组患者的一般资料、24hPP及24hPPI,分析高血压患者合并冠心病的危险因素,分析高血压合并冠心病患者24hPP和24hPPI与Gensini积分的相关性,分析24hPP和24hPPI对高血压合并冠心病的预测价值.结果高血压合并冠心病组患者的年龄[(62.57±7.42)岁比(58.63±8.92)岁]、吸烟史占比(37.04%比19.79%)、低密度脂蛋白胆固醇(LDL-C)[(2.98±0.64)mmol/L比(2.75±0.58)mmol/L]、24hPP[(50.52±9.37)mm Hg比(47.26±8.69)mm Hg]、24hPPI[(0.42±0.07)比(0.37±0.08)]均高于高血压组,而高密度脂蛋白胆固醇(HDL-C)[(1.50±0.48)mmol/L比(1.68±0.52)mmol/L]低于高血压组,差异均有统计学意义(P<0.05).Logistic回归分析结果显示,年龄越大、LDL-C升高、24hPP升高和24hPPI升高均是高血压患者合并冠心病的危险因素,而不吸烟则是高血压患者合并冠心病的保护因素(P<0.05);Pearson分析显示,24hPP和24hPPI与Gensini积分均呈正相关(P<0.05);24hPP和24hPPI对高血压合并冠心病均有一定的预测价值,24hPP的曲线下面积为0.669(95%CI 0.577~0.762),截断值取49.44 mm Hg时,敏感度为66.70%,特异度为63.50%,约登指数为0.302;24hPPI的曲线下面积为0.730(95%CI 0.646~0.813),截断值取0.39时,敏感度为70.40%,特异度为72.90%,约登指数为0.433.结论24hPP和24hPPI升高均是高血压患者合并冠心病的危险因素,且与Gensini积分均呈正相关,二者对高血压合并冠心病均有一定的预测和筛查价值,且24hPPI的预测和筛查价值更高.Objective To investigate the relationship between 24 hours dynamic pulse pressure(24hPP)and 24 hours dynamic pulse pressure index(24hPPI)and coronary heart disease in patients with hypertension.Methods 150 cases of primary hypertension treated in Ankang Traditional Chinese Medicine Hospital from January 2019 to June 2019 were selected.According to whether they were combined with coronary heart disease,the patients were divided into simple hypertension group(96 cases)and hypertension complicated by coronary heart disease group(54 cases).The general data and 24hPP and 24hPPI of the two groups were compared;the risk factors of hypertension patients with coronary heart disease were analyzed;the correlation between 24hPP and 24hPPI and Gensini score of hypertension patients with coronary heart disease were analyzed and the predictive value of 24hPP and 24hPPI to hypertension patients with coronary heart disease was analyzed.Results The age[(62.57±7.42)years old vs.(58.63±8.92)years old],proportion of smoking history(37.04%vs.19.79%),low density lipoprotein cholesterol(LDL-C)[(2.98±0.64)mmol/L vs.(2.75±0.58)mmol/L],24hpp[(50.52±9.37)mm Hg vs.(47.26±8.69)mm Hg],24hPPI[(0.42±0.07)vs.(0.37±0.08)]in hypertension combined with coronary heart disease group were higher than those in simple hypertension group,while high density lipoprotein cholesterol(HDL-C)[(1.50±0.48)mmol/L vs.(1.68±0.52)mmol/L]was lower than that in hypertension group,the difference was statistically significant(P<0.05).The results of Logistic regression analysis showed that the older age,the higher LDL-C,24hPP and 24hPPI were the risk factors of coronary heart disease in patients with hypertension,while non-smoking was the protective factor(P<0.05).Pearson analysis showed that there were a positive correlation between both 24hPP and 24hPPI and Gensini score(P<0.05);24hPP and 24hPPI had certain predictive value for hypertension complicated by coronary heart disease.The area under the curve of 24hPP was 0.669(95%CI 0.577-0.762).When the cutoff valu

关 键 词：高血压 冠状动脉疾病 动态脉压 动态脉压指数 

分 类 号：R544.1[医药卫生—心血管疾病]