冠心病患者拔牙术中心率收缩压乘积指标变化规律及临床意义  

Change pattern of heart rate systolic product index and clinical significance in patients with coronary artery disease during tooth extraction

作　　者：刘银花[1] 段向青[1] 丁芳[1] 王杰[1] 郭海燕[1] 刘林 LIU Yin-hua;DUAN Xiang-qing;DING Fang;WANG Jie;GUO Hai-yan;LIU Lin(Beijing Anzhen Hospital Dental Medical Center,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院口腔医疗中心,北京100029

出　　处：《中华老年口腔医学杂志》2022年第5期274-277,287,共5页Chinese Journal of Geriatric Dentistry

基　　金：首都医科大学基础-临床科研合作基金(项目编号:16JL06)。

摘　　要：目的:分析冠心病患者拔牙术中“心率收缩压乘积”(Rate-Pressure-Product,RPP)指标变化规律及其临床意义。方法:记录1802例冠心病患者拔牙术中各阶段收缩压(SBP)、心率(HR)数据,计算RPP值并进行对比分析。结果:拔牙术中各阶段RPP值变化有显著性差异(P<0.01),表现为一定规律波动;26%的患者麻醉中、43%的患者拔牙手术过程中RPP值>12000;183例(10.2%)患者拔牙术中出现心脏相关不适,其中168例患者RPP值>12000,占92%;心脏支架术后、搭桥术后及规范药物治疗的冠心病患者拔牙过程中RPP值的变化无统计学差异。结论:心率收缩压乘积(RPP)是反映心肌耗氧量的常用临床指标,冠心病患者拔牙术中监测RPP变化,及时采取相应措施,有助于减少术中发生心血管意外的风险;经过系统治疗、病情稳定的冠心病患者可以安全完成牙拔除术。Objective:To analyze the change pattern of“rate-pressure-product”(RPP)index in patients with coronary heart disease(CHD)during tooth extraction and its clinical significance.Methods:The systolic blood pressure(SBP)and heart rate(HR)data of 1802 patients with coronary artery disease were recorded at each stage of extraction,and the RPP values were calculated and analyzed for comparison.Results:1.There were significant differences in the changes of RPP values in each stage of tooth extraction(P<0.01),showing a certain regular fluctuations;2.26%of patients had RPP values>12000 during anesthesia and 43%during dental extraction;3.183 patients(10.2%)had cardiac-related discomfort during dental extraction,of which 168 patients(92%)had RPP values>12000.4.There was no statistical difference in the changes of RPP values at each stage during tooth extraction in patients with coronary artery disease after cardiac stenting,after bypass surgery and standardized drug therapy.Conclusion:1.Heart rate systolic pressure product(RPP)is a common clinical index reflecting myocardial oxygen consumption,and monitoring the changes of RPP during tooth extraction in patients with coronary heart disease and taking corresponding measures in time can help reduce the risk of intraoperative cardiovascular accidents;2.Patients with coronary heart disease who have undergone systematic treatment and stable conditions can safely complete tooth extraction.

关 键 词：冠心病 拔牙 RPP 

分 类 号：R782[医药卫生—口腔医学]