H型高血压合并冠心病患者24h动态血压变异系数及乳酸脱氢酶水平与冠状动脉粥样硬化病变程度的相关性  

Correlation of the coefficient of 24-hour ambulatory blood pressure variation with lactate dehydrogenase levels and the degrees of atherosclerotic lesions in H-type hypertension patients combined with coronary heart disease

作　　者：王卓[1] 司澳洋 张培勇[1] Wang Zhuo;Si Aoyang;Zhang Peiyong(The First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan,China)

机构地区：[1]新乡医学院第一附属医院,河南卫辉453100

出　　处：《临床心身疾病杂志》2024年第4期47-51,共5页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划软科学项目(编号LHGJ20200588)。

摘　　要：目的 探究H型高血压合并冠心病患者24 h动态血压变异系数及乳酸脱氢酶(LDH)水平与冠状动脉粥样硬化病变程度的相关性。方法 对40例H型高血压合并冠心病患者进行冠状动脉造影检查,以Gensini积分表示冠状动脉粥样硬化病变严重程度,以酶联免疫吸附法检测患者LDH水平,监测患者24 h动态血压,计算24 h动态血压变异系数。比较不同冠状动脉病变程度患者24 h动态血压变异系数及LDH水平。24 h动态血压变异系数及LDH水平与动脉粥样硬化病变程度的相关性采用Pearson相关分析,对重度冠状动脉粥样硬化的影响因素行多因素Logistic回归分析。结果 入组冠状动脉粥样硬化轻度病变患者12例,中度和重度病变患者各14例。重度及中度病变患者血清同型半胱氨酸(Hcy)、LDH水平及24 h血压变异系数均高于轻度病变患者(P<0.01),重度病变患者血清Hcy、LDH水平及24 h血压变异系数均高于中度病变患者(P<0.01)。Pearson相关分析显示,血压变异系数、LDH水平与Gensini积分均呈正相关(P<0.05或0.01)。多因素Logistic回归分析显示,24h血压变异系数(OR=1.326,95%CI为1.040~1.691,P<0.05)及LDH水平(OR=1.311,95%CI为1.048~1.639,P<0.05)为重度冠状动脉粥样硬化发生的危险因素。结论 H型高血压合并冠心病患者24 h动态血压变异系数及LDH水平较高,且可能与冠状动脉粥样硬化病变程度加重有关。Objective To explore the correlation of the coefficient of 24-hour ambulatory blood pressure(BP)variation with lactate dehydrogenase(LDH)levels and the degrees of atherosclerotic lesions in H-type hypertension(HTH)patients combined with coronary heart disease(CHD).Methods Coronary angiography examinations were performed for 40 patients with HTH+CHD,Gensini scores used to indicate the degrees of atherosclerotic lesions,LDH levels detected using enzyme-linked immunosorbent assay,24-hour ambulatory BPs monitored,and the coefficient of 24-hour ambulatory BP variation calculated.Coefficients of 24-hour ambulatory BP variation and LDH levels were compared among patients with different degrees of atherosclerotic lesions.The correlations of the coefficient of 24-hour ambulatory BP variation with LDH levels and the degrees of atherosclerotic lesions were analyzed using Pearson correlation,so were the influencing factors of severe atherosclerosis using multiple factor Logistic regression.Results Of 40 HTH+CHD patients 12 were mild,14 moderate and 14 severe atherosclerotic lesion.Serum homocysteine(Hcy)and LDH levels as well as the coefficient of 24-hour ambulatory BP variation were higher i n severe a nd moderate t ha n mild patients with atherosclerotic lesion(P<0.01)so were those in severe than moderate ones(P<0.01).Pearson correlation analysis showed that coefficient of BP variation and LDH levels were positively correlated with Gensini scores(P<0.05 or 0.01).Multivariate Logistic regression analysis showed that the coefficient of 24-hour BP variation(OR=1.326,95%CI 1.040~1.691,P<0.05)and LDH levels(OR=1.311,95%CI 1.048~1.639,P<0.05)were risk factors for severe atherosclerosis.Conclusion The coefficient of 24-hour ambulatory BP variation and LDH levels in patients with HTH+CHD are higher,which may be related to the aggravation of coronary atherosclerosis.

关 键 词：冠心病 H型高血压 乳酸脱氢酶 动态血压变异系数 动脉粥样硬化 

分 类 号：R543.31[医药卫生—心血管疾病] R544.1[医药卫生—内科学]