皖北地区高血压合并急性冠脉综合征患者临床特征、危险分层及临床预后相关性分析  

Risk stratification of clinical characteristics and correlation analysis of clinical prognosis in patients with hypertension complicated by acute coronary syndrome in northern Anhui

作　　者：蒋南 包炳蔚 丁丝雨 季春斐 钱少环 王洪巨[1,2] 李妙男[2] JIANG Nan;BAO Bingwei;DING Siyu;JI Chunfei;QIAN Shaohuan;WANG Hongju;LI Miaonan(Department of General Practice,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院全科医学科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院心血管内科

出　　处：《中华全科医学》2023年第8期1287-1290,1350,共5页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(81970313);蚌埠医学院512人才培育计划(by51201317,by51201105);蚌埠医学院自然科学研究重点项目(2020byzd109);安徽省教育厅自然科学研究重点项目(2022AH051477)。

摘　　要：目的分析皖北地区高血压合并急性冠脉综合征(ACS)患者临床特征、危险分层,探讨高血压合并ACS患者高危因素,指导临床工作。方法选取皖北地区2018年10月-2019年7月于蚌埠医学院第一附属医院行冠状动脉造影确诊的ACS患者426例,根据是否合并高血压分为高血压合并ACS组(HBP组,252例)和非高血压合并ACS组(NHBP组,174例)。平均随访15个月,记录ACS组患者术后主要不良心血管事件。采用单因素分析筛选指标纳入二元logistic回归进行独立危险因素分析。结果与NHBP组患者相比,HBP组患者年龄、尿酸、肌酐、甘油三酯水平较高;早发冠心病比例较低;三支病变比例更高,Gensini评分更高(P<0.05)。二元logistic回归显示,年龄增大(OR=1.163,95%CI:1.085~1.247,P<0.01)、男性(OR=2.615,95%CI:1.192~5.737,P=0.016)、早发冠心病(OR=7.775,95%CI:1.772~34.113,P=0.007)、高TG(OR=1.337,95%CI:1.104~1.619,P=0.003)是高血压合并ACS患者的独立危险因素(P<0.05)。结论年龄增大、男性、早发冠心病、高TG等因素与高血压合并ACS患者密切相关,指导临床工作中加强筛查及干预。Objective To analyze the clinical characteristics and risk stratification of hypertension patients with acute coronary syndrome(ACS)in northern Anhui,to discuss the high risk factors of hypertensive patients with ACS,and to guide the clinical work.Methods A total of 426 patients with ACS,diagnosed by coronary angiography in the First Affiliated Hospital of Bengbu Medical College from October 2018 to July 2019 in northern Anhui province.They were divided into hypertensive ACS group(HBP group,252 cases)and non-hypertensive ACS group(NHBP group,174 cases)according to whether they were complicated with hypertension.The average follow-up was 15 months,and major adverse cardiovascular events(MACES)were recorded in the ACS group.Multivariate logistic regression was used to analyze independent risk factors.Results Compared with the NHBP group,patients in the HBP group had higher age,uric acid,creatinine and triglyceride(TG)levels;The rate of early coronary heart disease was lower;the proportion of three-vessel lesions was higher;and the Gensini score was higher(P<0.05).Binary logistic regression showed that,getting older(OR=1.163,95%CI:1.085-1.247,P<0.01),Male(OR=2.615,95%CI:1.192-5.737,P=0.016),early-onset coronary heart disease(OR=7.775,95%CI:1.772-34.113,P=0.007),high TG(OR=1.337,95%CI:1.104-1.619,P=0.003)were independent risk factors for patients with hypertension combined with ACS(P<0.05).Conclusion Getting older,male,early-onset coronary heart disease,high TG and other factors are closely related to the patients with hypertension complicated with ACS,which guide to strengthen clinical screening and intervention in clinical work.

关 键 词：急性冠脉综合征 高血压 GRACE危险评分 TIMI危险评分 主要不良心血管事件 

分 类 号：R544.1[医药卫生—心血管疾病] R543.3[医药卫生—内科学]